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Association between early pulmonary arterial pressure measurements and bronchopulmonary dysplasia or mortality in very preterm infants: a prospective cohort study
  1. Mustafa Senol Akin1,
  2. Gökce Kas2,
  3. Emre Aydin3,
  4. Aslıhan Kose Cetinkaya1,
  5. Ibrahim Ece2,
  6. Fatma Nur Sari4,
  7. Evrim Alyamac Dizdar4
  1. 1 Department of Neonatology, Ankara City Hospital Children's Hospital, Ankara, Turkey
  2. 2 Department of Pediatric Cardiology, Ankara City Hospital Children's Hospital, Ankara, Turkey
  3. 3 Department of Pediatrics, Ankara City Hospital Children's Hospital, Ankara, Turkey
  4. 4 Department of Neonatology, Ankara City Hospital Children's Hospital, University of Health Sciences, Cankaya, Ankara, Turkey
  1. Correspondence to Dr Mustafa Senol Akin; mustafasenolakin{at}gmail.com

Abstract

Background Prematurity is a significant risk for bronchopulmonary dysplasia related pulmonary artery pressure.

Objective To determine the association between pulmonary artery pressure in the early days of life and the development of bronchopulmonary dysplasia or mortality.

Methods This prospective observational cohort study included infants born at <32 weeks and weighing <1500 g. Pulmonary artery pressure was measured between postnatal days 3 and 7. Pulmonary hypertension was defined as systolic pulmonary artery pressure ≥40 mm Hg or systolic pulmonary artery pressure/systolic blood pressure >0.5 (pulmonary hypertension criterion-1). Infants were categorised into pulmonary hypertension and non-pulmonary hypertension groups. The primary endpoint was bronchopulmonary dysplasia or mortality. Receiver operating characteristic analysis established a new threshold value for predicting bronchopulmonary dysplasia or mortality (pulmonary hypertension criterion-2). Infants were reanalysed according to new criteria.

Results A total of 329 infants were included in this study. Moderate-to-severe pulmonary hypertension was identified in 24% (n=79) of the infants. The pulmonary hypertension group exhibited a significantly lower gestational age, lower birth weight and a higher incidence of small for gestational age. Systolic pulmonary artery pressure >25 mm Hg or systolic pulmonary artery pressure/systolic blood pressure >0.35 was defined as the pulmonary hypertension criterion-2. Logistic regression analysis identified pulmonary hypertension criterion-2 as an independent risk factor for moderate-to-severe bronchopulmonary dysplasia or mortality (OR 2.67, 95% CI 1.3 to 5.51, p<0.01).

Conclusion Pulmonary artery pressure exceeding 25 mm Hg in the early days of life may be considered a potential risk factor for bronchopulmonary dysplasia or mortality.

  • Neonatology
  • Paediatrics
  • Intensive Care Units, Neonatal
  • Cardiology

Data availability statement

Data may be obtained from a third party and are not publicly available. All data relevant to the study are included in the article or uploaded as supplementary information. Approval for the analysis of patient data was obtained from the parents. However, due to the respect for patient privacy and the fact that the patients themselves have not made decisions regarding the sharing of their information, these data will only be shared with third parties when absolutely necessary and under restricted conditions.

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Data availability statement

Data may be obtained from a third party and are not publicly available. All data relevant to the study are included in the article or uploaded as supplementary information. Approval for the analysis of patient data was obtained from the parents. However, due to the respect for patient privacy and the fact that the patients themselves have not made decisions regarding the sharing of their information, these data will only be shared with third parties when absolutely necessary and under restricted conditions.

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Footnotes

  • X @museakin

  • Contributors MSA and EAD were responsible for the data collection and analysis. MSA wrote the manuscript. EAD reviewed and revised the manuscript accordingly. GK performed the echocardiography examination, EA recorded the data, IE planned the method, and FNS and AKC performed the statistical analysis. MSA is guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.