Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Health-care utilization and respiratory morbidities in preterm infants with pulmonary hypertension

Journal of Perinatology volume 33, pages 543–547 (2013)Cite this article

Subjects

Abstract

Objective:

To assess health-care utilization and risk of respiratory morbidities in preterm infants with bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH).

Study Design:

Retrospective data were obtained from subjects (n=109) attending a BPD clinic. Subjects were stratified by the presence or absence of PH before and after 2 months of age. Analytic methods included t-tests, χ2 tests and regression.

Result:

Subjects with BPD and PH present after 2 months of age were hospitalized for 2.2 months longer than those without PH (P=0.02). These subjects were 4.5 times more likely to receive home supplemental oxygen or mechanical ventilation (P=0.03). No difference in the risk of respiratory morbidities after initial hospital discharge was seen with PH.

Conclusion:

PH in preterm infants is associated with longer initial hospitalizations and a higher likelihood of requiring home respiratory support. This has implications for counseling families and reducing the medical, psychosocial, and economic burden of BPD and PH.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR, Walsh MC et al. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics 2010; 126: 443–456.

    Article  Google Scholar 

  2. Bancalari E, Claure N, Sosenko IR . Bronchopulmonary dysplasia: changes in pathogenesis, epidemiology and definition. Semin Neonatol 2003; 8: 63–71.

    Article  Google Scholar 

  3. Subhedar NV . Recent advances in diagnosis and management of pulmonary hypertension in chronic lung disease. Acta Paediatr Suppl 2004; 93: 29–32.

    Article  CAS  Google Scholar 

  4. Berger RM, Beghetti M, Humpl T, Raskob GE, Ivy DD, Jing ZC et al. Clinical features of paediatric pulmonary hypertension: a registry study. Lancet 2012; 379: 537–546.

    Article  Google Scholar 

  5. Kim DH, Kim HS, Choi CW, Kim EK, Kim BI, Choi JH . Risk factors for pulmonary artery hypertension in preterm infants with moderate or severe bronchopulmonary dysplasia. Neonatology 2012; 101: 40–46.

    Article  Google Scholar 

  6. An HS, Bae EJ, Kim GB, Kwon BS, Beak JS, Kim EK et al. Pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. Korean Circ J 2010; 40: 131–136.

    Article  Google Scholar 

  7. Khemani E, McElhinney DB, Rhein L, Andrade O, Lacro RV, Thomas KC et al. Pulmonary artery hypertension in formerly premature infants with bronchopulmonary dysplasia: clinical features and outcomes in the surfactant era. Pediatrics 2007; 120: 1260–1269.

    Article  Google Scholar 

  8. Slaughter JL, Pakrashi T, Jones DE, South AP, Shah TA . Echocardiographic detection of pulmonary hypertension in extremely low birth weight infants with bronchopulmonary dysplasia requiring prolonged positive pressure ventilation. J Perinatol 2011.

  9. Bhat R, Salas AA, Foster C, Carlo WA, Ambalavanan N . Prospective analysis of pulmonary hypertension in extremely low birth weight infants. Pediatrics 2012; 129 (3): e682–e689.

    Article  Google Scholar 

  10. Kumar VH, Hutchison AA, Lakshminrusimha S, Morin FC, Wynn RJ, Ryan RM . Characteristics of pulmonary hypertension in preterm neonates. J Perinatol 2007; 27: 214–219.

    Article  CAS  Google Scholar 

  11. Collaco JM, Romer LH, Stuart BD, Coulson JD, Everett AD, Lawson EE et al. Frontiers in pulmonary hypertension in infants and children with bronchopulmonary dysplasia. Pediatr Pulmonol 2012.

  12. Oken E, Kleinman KP, Rich-Edwards J, Gillman MW . A nearly continuous measure of birth weight for gestational age using a United States national reference. BMC Pediatr 2003; 3: 6.

    Article  Google Scholar 

  13. Liang KY, Zeger SL . Longitudinal data-analysis using generalized linear-models. Biometrika 1986; 73: 13–22.

    Article  Google Scholar 

  14. Parker TA, Abman SH . The pulmonary circulation in bronchopulmonary dysplasia. Semin Neonatol 2003; 8: 51–61.

    Article  Google Scholar 

  15. Dhillon R . The management of neonatal pulmonary hypertension. Arch Dis Child Fetal Neonatal Ed 2011.

  16. Abman SH . Monitoring cardiovascular function in infants with chronic lung disease of prematurity. Arch Dis Child Fetal Neonatal Ed 2002; 87: F15–F18.

    Article  CAS  Google Scholar 

  17. Kim GB . Pulmonary hypertension in infants with bronchopulmonary dysplasia. Korean J Pediatr 2010; 53: 688–693.

    Article  Google Scholar 

  18. Carmosino MJ, Friesen RH, Doran A, Ivy DD . Perioperative complications in children with pulmonary hypertension undergoing noncardiac surgery or cardiac catheterization. Anesth Analg 2007; 104: 521–527.

    Article  Google Scholar 

  19. van der Griend BF, Lister NA, McKenzie IM, Martin N, Ragg PG, Sheppard SJ et al. Postoperative mortality in children after 101,885 anesthetics at a tertiary pediatric hospital. Anesth Analg 2011; 112: 1440–1447.

    Article  Google Scholar 

  20. Healy F, Hanna BD, Zinman R . Clinical practice. The impact of lung disease on the heart and cardiac disease on the lungs. Eur J Pediatr 2010; 169: 1–6.

    Article  Google Scholar 

  21. Mourani PM, Sontag MK, Younoszai A, Ivy DD, Abman SH . Clinical utility of echocardiography for the diagnosis and management of pulmonary vascular disease in young children with chronic lung disease. Pediatrics 2008; 121: 317–325.

    Article  Google Scholar 

  22. Lantos JD, Meadow WL . Costs and end-of-life care in the NICU: lessons for the MICU? J Law Med Ethics 2011; 39: 194–200.

    Article  Google Scholar 

Download references

Acknowledgements

We thank the families who participated in this study and research assistant Timothy Ryan. This work did not receive any internal or external funding.

Author information

Authors and Affiliations

  1. Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    B D Stuart, S E J Choi, S A McGrath-Morrow & J M Collaco

  2. The Helen B Taussig Congenital Heart Center, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    P Sekar & J D Coulson

Authors
  1. B D Stuart
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P Sekar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J D Coulson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S E J Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S A McGrath-Morrow
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J M Collaco
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J M Collaco.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies the paper on the Journal of Perinatology website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stuart, B., Sekar, P., Coulson, J. et al. Health-care utilization and respiratory morbidities in preterm infants with pulmonary hypertension. J Perinatol 33, 543–547 (2013). https://doi.org/10.1038/jp.2012.170

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2012.170

Keywords

This article is cited by

Search

Advanced search

Quick links