The Impact of Pulmonary Hypertension in Preterm Infants with Severe Bronchopulmonary Dysplasia through 1 Year

Children's Hospital Neonatal Consortium Severe BPD Focus Group

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: To assess the effect of pulmonary hypertension on neonatal intensive care unit mortality and hospital readmission through 1 year of corrected age in a large multicenter cohort of infants with severe bronchopulmonary dysplasia. Study design: This was a multicenter, retrospective cohort study of 1677 infants born <32 weeks of gestation with severe bronchopulmonary dysplasia enrolled in the Children's Hospital Neonatal Consortium with records linked to the Pediatric Health Information System. Results: Pulmonary hypertension occurred in 370 out of 1677 (22%) infants. During the neonatal admission, pulmonary hypertension was associated with mortality (OR 3.15, 95% CI 2.10-4.73, P <.001), ventilator support at 36 weeks of postmenstrual age (60% vs 40%, P <.001), duration of ventilation (72 IQR 30-124 vs 41 IQR 17-74 days, P <.001), and higher respiratory severity score (3.6 IQR 0.4-7.0 vs 0.8 IQR 0.3-3.3, P <.001). At discharge, pulmonary hypertension was associated with tracheostomy (27% vs 9%, P <.001), supplemental oxygen use (84% vs 61%, P <.001), and tube feeds (80% vs 46%, P <.001). Through 1 year of corrected age, pulmonary hypertension was associated with increased frequency of readmission (incidence rate ratio [IRR] = 1.38, 95% CI 1.18-1.63, P <.001). Conclusions: Infants with severe bronchopulmonary dysplasia-associated pulmonary hypertension have increased morbidity and mortality through 1 year of corrected age. This highlights the need for improved diagnostic practices and prospective studies evaluating treatments for this high-risk population.

Original languageEnglish (US)
JournalJournal of Pediatrics
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Bronchopulmonary Dysplasia
Pulmonary Hypertension
Premature Infants
Mortality
Health Information Systems
Patient Readmission
Tracheostomy
Neonatal Intensive Care Units
Mechanical Ventilators
Ventilation
Cohort Studies
Retrospective Studies
Prospective Studies
Pediatrics
Oxygen
Morbidity
Pregnancy
Incidence
Population

Keywords

  • bronchopulmonary dysplasia
  • epidemiology
  • outcomes
  • pulmonary hypertension

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

The Impact of Pulmonary Hypertension in Preterm Infants with Severe Bronchopulmonary Dysplasia through 1 Year. / Children's Hospital Neonatal Consortium Severe BPD Focus Group.

In: Journal of Pediatrics, 01.01.2018.

Research output: Contribution to journalArticle

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title = "The Impact of Pulmonary Hypertension in Preterm Infants with Severe Bronchopulmonary Dysplasia through 1 Year",
abstract = "Objectives: To assess the effect of pulmonary hypertension on neonatal intensive care unit mortality and hospital readmission through 1 year of corrected age in a large multicenter cohort of infants with severe bronchopulmonary dysplasia. Study design: This was a multicenter, retrospective cohort study of 1677 infants born <32 weeks of gestation with severe bronchopulmonary dysplasia enrolled in the Children's Hospital Neonatal Consortium with records linked to the Pediatric Health Information System. Results: Pulmonary hypertension occurred in 370 out of 1677 (22{\%}) infants. During the neonatal admission, pulmonary hypertension was associated with mortality (OR 3.15, 95{\%} CI 2.10-4.73, P <.001), ventilator support at 36 weeks of postmenstrual age (60{\%} vs 40{\%}, P <.001), duration of ventilation (72 IQR 30-124 vs 41 IQR 17-74 days, P <.001), and higher respiratory severity score (3.6 IQR 0.4-7.0 vs 0.8 IQR 0.3-3.3, P <.001). At discharge, pulmonary hypertension was associated with tracheostomy (27{\%} vs 9{\%}, P <.001), supplemental oxygen use (84{\%} vs 61{\%}, P <.001), and tube feeds (80{\%} vs 46{\%}, P <.001). Through 1 year of corrected age, pulmonary hypertension was associated with increased frequency of readmission (incidence rate ratio [IRR] = 1.38, 95{\%} CI 1.18-1.63, P <.001). Conclusions: Infants with severe bronchopulmonary dysplasia-associated pulmonary hypertension have increased morbidity and mortality through 1 year of corrected age. This highlights the need for improved diagnostic practices and prospective studies evaluating treatments for this high-risk population.",
keywords = "bronchopulmonary dysplasia, epidemiology, outcomes, pulmonary hypertension",
author = "{Children's Hospital Neonatal Consortium Severe BPD Focus Group} and Lagatta, {Joanne M.} and Hysinger, {Erik B.} and Isabella Zaniletti and Wymore, {Erica M.} and Shilpa Vyas-Read and Sushmita Yallapragada and Nelin, {Leif D.} and Truog, {William E.} and Padula, {Michael A.} and Porta, {Nicolas F.M.} and Savani, {Rashmin C.} and Potoka, {Karin P.} and Kawut, {Steven M.} and Robert DiGeronimo and Girija Natarajan and Huayan Zhang and Grover, {Theresa R.} and Engle, {William A.} and Karna Murthy",
year = "2018",
month = "1",
day = "1",
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language = "English (US)",
journal = "Journal of Pediatrics",
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AU - Children's Hospital Neonatal Consortium Severe BPD Focus Group

AU - Lagatta, Joanne M.

AU - Hysinger, Erik B.

AU - Zaniletti, Isabella

AU - Wymore, Erica M.

AU - Vyas-Read, Shilpa

AU - Yallapragada, Sushmita

AU - Nelin, Leif D.

AU - Truog, William E.

AU - Padula, Michael A.

AU - Porta, Nicolas F.M.

AU - Savani, Rashmin C.

AU - Potoka, Karin P.

AU - Kawut, Steven M.

AU - DiGeronimo, Robert

AU - Natarajan, Girija

AU - Zhang, Huayan

AU - Grover, Theresa R.

AU - Engle, William A.

AU - Murthy, Karna

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: To assess the effect of pulmonary hypertension on neonatal intensive care unit mortality and hospital readmission through 1 year of corrected age in a large multicenter cohort of infants with severe bronchopulmonary dysplasia. Study design: This was a multicenter, retrospective cohort study of 1677 infants born <32 weeks of gestation with severe bronchopulmonary dysplasia enrolled in the Children's Hospital Neonatal Consortium with records linked to the Pediatric Health Information System. Results: Pulmonary hypertension occurred in 370 out of 1677 (22%) infants. During the neonatal admission, pulmonary hypertension was associated with mortality (OR 3.15, 95% CI 2.10-4.73, P <.001), ventilator support at 36 weeks of postmenstrual age (60% vs 40%, P <.001), duration of ventilation (72 IQR 30-124 vs 41 IQR 17-74 days, P <.001), and higher respiratory severity score (3.6 IQR 0.4-7.0 vs 0.8 IQR 0.3-3.3, P <.001). At discharge, pulmonary hypertension was associated with tracheostomy (27% vs 9%, P <.001), supplemental oxygen use (84% vs 61%, P <.001), and tube feeds (80% vs 46%, P <.001). Through 1 year of corrected age, pulmonary hypertension was associated with increased frequency of readmission (incidence rate ratio [IRR] = 1.38, 95% CI 1.18-1.63, P <.001). Conclusions: Infants with severe bronchopulmonary dysplasia-associated pulmonary hypertension have increased morbidity and mortality through 1 year of corrected age. This highlights the need for improved diagnostic practices and prospective studies evaluating treatments for this high-risk population.

AB - Objectives: To assess the effect of pulmonary hypertension on neonatal intensive care unit mortality and hospital readmission through 1 year of corrected age in a large multicenter cohort of infants with severe bronchopulmonary dysplasia. Study design: This was a multicenter, retrospective cohort study of 1677 infants born <32 weeks of gestation with severe bronchopulmonary dysplasia enrolled in the Children's Hospital Neonatal Consortium with records linked to the Pediatric Health Information System. Results: Pulmonary hypertension occurred in 370 out of 1677 (22%) infants. During the neonatal admission, pulmonary hypertension was associated with mortality (OR 3.15, 95% CI 2.10-4.73, P <.001), ventilator support at 36 weeks of postmenstrual age (60% vs 40%, P <.001), duration of ventilation (72 IQR 30-124 vs 41 IQR 17-74 days, P <.001), and higher respiratory severity score (3.6 IQR 0.4-7.0 vs 0.8 IQR 0.3-3.3, P <.001). At discharge, pulmonary hypertension was associated with tracheostomy (27% vs 9%, P <.001), supplemental oxygen use (84% vs 61%, P <.001), and tube feeds (80% vs 46%, P <.001). Through 1 year of corrected age, pulmonary hypertension was associated with increased frequency of readmission (incidence rate ratio [IRR] = 1.38, 95% CI 1.18-1.63, P <.001). Conclusions: Infants with severe bronchopulmonary dysplasia-associated pulmonary hypertension have increased morbidity and mortality through 1 year of corrected age. This highlights the need for improved diagnostic practices and prospective studies evaluating treatments for this high-risk population.

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KW - epidemiology

KW - outcomes

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