PMID- 30617286
OWN - NLM
STAT- In-Data-Review
LR  - 20190226
IS  - 1476-5543 (Electronic)
IS  - 0743-8346 (Linking)
VI  - 39
IP  - 3
DP  - 2019 Mar
TI  - Death or resolution: the "natural history" of pulmonary hypertension in
      bronchopulmonary dysplasia.
PG  - 415-425
LID - 10.1038/s41372-018-0303-8 [doi]
AB  - OBJECTIVES: The primary objective was to describe the early "natural history" of 
      pulmonary hypertension (PH) in the premature population. The secondary objective 
      was to describe factors associated with poor outcomes in the premature population
      with PH at 36 weeks post-menstrual age (PMA). STUDY DESIGN: Retrospective chart
      review of patients followed at our institution from 2000 to 2017 with
      echocardiographic (ECHO) evidence of PH at 36 weeks PMA, and born </= 32 weeks
      estimated gestational age (GA). Cox regression was used for survival analysis.
      RESULTS: Sixty-one patients with PH (26.5 +/- 1.5 weeks at birth) were included. 
      All PH patients had bronchopulmonary dysplasia (BPD), with 89% considered severe;
      38% were small for gestational age. Necrotizing enterocolitis requiring surgery
      was common (25%). Use of post-natal steroids (HR 11.02, p = 0.01) and increased
      severity of PH (HR 1.05, p < 0.001) were associated with mortality. Pulmonary
      vein stenosis (PVS) was documented in 26% of the PH cohort, but not associated
      with increased mortality. ECHO estimation of pulmonary artery pressure (PAP) was 
      available in 84%. PAP was higher in those who died (sPAP/sBP ratio 1.09 +/- 27 vs
      0.83 +/- 20 %, p = 0.0002). At follow-up (mean 250 +/- 186 weeks PMA), 72% of the
      PH cohort was alive. Most survivors (66%) had resolution of their PH on their
      most recent ECHO; 31% remained on PH therapy. CONCLUSION: PH resolved in most
      survivors in this study population. Mortality in those with BPD-PH was associated
      with male sex, post-natal steroid use, and increased severity of PH, but not with
      PVS.
FAU - Altit, Gabriel
AU  - Altit G
AUID- ORCID: http://orcid.org/0000-0001-5141-0964
AD  - Division of Neonatology - Department of Pediatrics - McGill University, Montreal 
      Children's Hospital - McGill University Health Centre, Montreal, Canada.
      gabriel.altit@mail.mcgill.ca.
FAU - Bhombal, Shazia
AU  - Bhombal S
AD  - Neonatal and Developmental Medicine, Stanford University School of Medicine -
      Lucile Packard Children's Hospital, Stanford, CA, USA.
FAU - Hopper, Rachel K
AU  - Hopper RK
AD  - Pediatric Cardiology, Stanford University School of Medicine - Lucile Packard
      Children's Hospital, Stanford, Stanford, CA, USA.
FAU - Tacy, Theresa A
AU  - Tacy TA
AD  - Pediatric Cardiology, Stanford University School of Medicine - Lucile Packard
      Children's Hospital, Stanford, Stanford, CA, USA.
FAU - Feinstein, Jeffrey
AU  - Feinstein J
AD  - Pediatric Cardiology, Stanford University School of Medicine - Lucile Packard
      Children's Hospital, Stanford, Stanford, CA, USA.
LA  - eng
PT  - Journal Article
DEP - 20190107
PL  - United States
TA  - J Perinatol
JT  - Journal of perinatology : official journal of the California Perinatal
      Association
JID - 8501884
EDAT- 2019/01/09 06:00
MHDA- 2019/01/09 06:00
CRDT- 2019/01/09 06:00
PHST- 2018/08/14 00:00 [received]
PHST- 2018/12/12 00:00 [accepted]
PHST- 2018/10/26 00:00 [revised]
PHST- 2019/01/09 06:00 [pubmed]
PHST- 2019/01/09 06:00 [medline]
PHST- 2019/01/09 06:00 [entrez]
AID - 10.1038/s41372-018-0303-8 [doi]
AID - 10.1038/s41372-018-0303-8 [pii]
PST - ppublish
SO  - J Perinatol. 2019 Mar;39(3):415-425. doi: 10.1038/s41372-018-0303-8. Epub 2019
      Jan 7.