Mortality among infants with evolving bronchopulmonary dysplasia increases with major surgery and with pulmonary hypertension

J Perinatol. 2017 Sep;37(9):1043-1046. doi: 10.1038/jp.2017.89. Epub 2017 Jun 15.

Abstract

Objective: To assess whether mortality in patients with evolving bronchopulmonary dysplasia (BPD, defined as ⩾28 days of oxygen exposure with lung disease) is independently associated with pulmonary arterial hypertension (PAH) and surgery.

Study design: Single institution retrospective birth cohort of preterm infants with gestational age (GA) 230/7 to 366/7 weeks, and evolving BPD delivered between 2001 and 2014. Surgery was classified as minor or major using published criteria. Mortality was analyzed by stepwise logistic regression analysis.

Results: Among 577 patients with evolving BPD, 33 (6%) died prior to discharge. Mortality decreased with GA (adjusted odds ratio (aOR): 0.69; 95% confidence interval (CI): 0.55, 0.87), birth weight Z-score (aOR: 0.69, 95% CI: 0.47, 0.996) and increased with PAH (aOR: 30, 95% CI: 2.1, 415), major surgery (aOR; 2.8, 95% CI: 1.3, 6.3), and PAH and surgery (aOR: 10.3, 95% CI: 2.5, 42.1).

Conclusion: Among preterm patients with evolving BPD, PAH and surgery are independently associated with mortality.

MeSH terms

  • Bronchopulmonary Dysplasia / mortality*
  • Bronchopulmonary Dysplasia / surgery
  • Case-Control Studies
  • Electrocardiography
  • Female
  • Gestational Age
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / mortality*
  • Infant
  • Infant, Extremely Premature
  • Infant, Newborn
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Logistic Models
  • Male
  • Retrospective Studies
  • Risk Factors