CHSJ

Curr Health Sci J, vol. 50, no. 3, 2024

Two-Year Outcomes in Preterm Infants Suffering from Moderate to Severe Bronchopulmonary Dysplasia with or without Associated Pulmonary Hypertension

[Original Paper]

I. BRANESCU(1,2), D.O. ALEXANDRU(3), S. VLADAREANU(1), A. KULKARNI(2,4)


(1)Carol Davila University of Medicine and Pharmacy Bucharest, Romania;
(2)St. George’s University Hospital, St George’s University, London, UK;
(3)University of Medicine and Pharmacy Craiova, Romania,
(4)Royal Brompton Hospital NHS Foundation Trust, London, UK


Abstract:

Objectives: to assess the impact of pulmonary hypertension (PH) on short and long-term respiratory and neurodevelopmental outcomes in extremely preterm infants, diagnosed with moderate to severe bronchopulmonary dysplasia (MSBPD). Study design: cohort study, with retrospective analysis of the medical records of infants born at ?32 weeks gestation admitted to a single neonatal tertiary centre from 2010 to 2020. Primary outcome was consistent with hospital re-admissions by 2 years post menstrual age. Neurodevelopment was assessed using Bayley’s Scales of Infant and Toddler Development 3rd edition (Bayley-III) as a secondary outcome. Results: 201 infants with no PH and 23 infants with PH were analysed. The PH group showed higher risk for respiratory and paediatric intensive care unit re-admission (65%) during the first 2 years of life (OR: 3.15; 95% CI: 1.28 to 7.78; p<0.5). In contrast to current published literature, our study showed that pulmonary hypertension complicating moderate to severe bronchopulmonary dysplasia had no negative impact on neurodevelopmental outcomes (OR: 1.87; 95% CI: 0.72 to 4.88; p value=0.19). However, in our population, ethnicity, chorioamnionitis and need for persistent ductus arteriosus treatment were all independently associated with poor neurodevelopmental outcomes (p values <0.5). Conclusion: infants with MSBPD associated pulmonary hypertension (MSBPD-PH) are more likely to need intensive care and respiratory hospital re-admissions. Ethnicity, chorioamnionitis and need for ductus arteriosus treatment are independently associated with poor neurodevelopmental outcomes regardless of the pulmonary hypertension status.


Keywords: Extreme prematurity, pulmonary hypertension, bronchopulmonary dysplasia, 2-years' outcomes.



Corresponding: Simona Vladareanu, Carol Davila University of Medicine and Pharmacy Bucharest, Romania, e-mail: simona.vladareanu@umfcd.ro


DOI 10.12865/CHSJ.50.03.11 - Download PDF
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