Risk Factors of Pulmonary Hypertension in Preterm Infants with Chronic Lung Disease

Abstract

Purpose Pulmonary hypertension (PH) is known as a major risk factor for preterm infants deaths, and associated with low gestational age, low birth weight, longer duration of oxygen therapy, low Apgar scores, and oligohydramnios. The aim of this study was to determine the risk factors for PH in preterm infants with chronic lung disease.

Methods A retrospective review was performed of data from 86 infants (<32 weeks of gestation) who diagnosed with chronic lung disease at Severance Children's Hospital from July 2006 to June 2011. PH was diagnosed on the basis of echocardiogram demonstrating elevated right ventricle pressure. The infants were divided into two groups: PH group (n=18) or control group (n=67).

Results PH group showed lower gestational age and underwent longer duration of oxygen therapy, mechanical ventilation, and hospitalization compared with control group. PH group received more surfactant therapy, and the frequency of the development of intraventricular hemorrhage (IVH) (≥G3) and severe chronic lung disease was higher in PH group than control group. According to multivariate analysis, IVH (≥G3) (OR=5.00, 95% CI=1.10-22.63, P=0.037) and severe BPD (OR=2.43, 95% CI=1.03-15.41, P=0.045) were found to be significant risk factors for PH in preterm infants with chronic lung disease.

Conclusion Pulmonary hypertension was significantly increased in preterm infants with chronic lung disease when associated with IVH (≥G3). We suggest that effort for early diagnosis and management for PH would be helpful in preterm infants with chronic lung disease when severe IVH was combined.