Erica McArthur, Karna Murthy, Isabella Zaniletti, Megha Sharma, Joanne Lagatta, Molly Ball, Nicholas Porta, Theresa Grover, Philip Levi, Michael Padula, Shannon Hamrick, Shilpa Vyas-Read, CHNC Severe BPD and Cardiology Focus Groups
Emory University School of Medicine and Children’s Healthcare of Atlanta. Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children’s Hospital of Chicago. University of Arkansas for Medical Sciences and Arkansas Children’s Hospital. Medical College of Wisconsin and Children’s Hospital of Wisconsin. Ohio State University Wexner Medical Center and Nationwide Children’s Hospital. University of Colorado School of Medicine and Children’s Hospital Colorado. Harvard Medical School and Boston Children’s Hospital. University of Pennsylvania and Children’s Hospital of Philadelphia.
United States
Journal of Pediatrics
J Pediatr 2024;
DOI: 10.1016/j.jpeds.2024.114252
Abstract
Objective: To evaluate associations between neonatal risk factors and pulmonary vein stenosis (PVS) among infants born preterm with severe bronchopulmonary dysplasia (sBPD).
Study design: We performed a case-control study of infants born from 2010 to 2022 at < 32 weeks’ gestation with sBPD among 46 neonatal intensive care units in the Children’s Hospitals Neonatal Consortium. Cases with PVS were matched to controls using epoch of diagnosis (2010-2016, 2017-2022) and hospital. Multivariable logistic regression analyses were utilized to evaluate PVS association with neonatal risk factors.
Results: From 10,171 preterm infants with sBPD, we identified 109 cases with PVS and matched those to 327 controls. The prevalence of PVS (1.07%) rose between epochs (0.8% in 2010-2016 to 1.2% in 2017-2022). Relative to controls, infants with PVS were more likely to be <500 grams at birth, to be small for gestational age <10th%ile (SGA), or have surgical necrotizing enterocolitis (NEC), atrial septal defects (ASD), or pulmonary hypertension (PH). In multivariable models, these associations persisted, and SGA, surgical NEC, ASD, and PH were each independently associated with PVS. Among infants on respiratory support at 36 weeks’ postmenstrual age, infants with PVS had 4.3-fold higher odds of receiving mechanical ventilation at 36 weeks’ postmenstrual age. Infants with PVS also had 3.6-fold higher odds of in-hospital mortality relative to controls.
Conclusions: In a large cohort of preterm infants with sBPD, multiple independent, neonatal risk factors are associated with PVS. These results lay important groundwork for the development of targeted screening to guide the diagnosis and management of PVS in preterm infants with sBPD.
Category
Stenosis or Obstruction of Normal Pulmonary Venous Connections
Pulmonary Hypertension Associated with Stenosis or Atresia of Pulmonary Veins
Incidence or Prevalence of Disease
Patient Factors Influencing the Onset, Severity or Outcome of Disease
Length of Life Associated with Pulmonary Venous Obstruction
Symptoms and Quality of Life Associated with Pulmonary Venous Obstruction
Year of Publication: 2024
Age Focus: Pediatric
Article Type: Retrospective Observational Case-Control or Other Comparative Studies
Article Access: Free PDF File or Full Text Article Available Through PubMed or DOI: No