The Impact of Late Onset Arterial Hypotension on Respiratory Outcome in Extremely Premature Infants.
Age of Onset
Bronchopulmonary Dysplasia
/ etiology
Ductus Arteriosus, Patent
/ epidemiology
Female
Gestational Age
Humans
Hypotension
/ complications
Incidence
Infant, Extremely Premature
Infant, Newborn
Logistic Models
Male
Multivariate Analysis
Prospective Studies
Risk Factors
Sepsis
/ epidemiology
Arterial hypotension
Bronchopulmonary dysplasia
Premature neonates
Journal
Neonatology
ISSN: 1661-7819
Titre abrégé: Neonatology
Pays: Switzerland
ID NLM: 101286577
Informations de publication
Date de publication:
2019
2019
Historique:
received:
21
07
2018
accepted:
27
09
2018
pubmed:
30
11
2018
medline:
18
12
2019
entrez:
29
11
2018
Statut:
ppublish
Résumé
In extremely premature infants, arterial hypotension in the first days after birth has been associated with an increased risk for bronchopulmonary dysplasia (BPD). Some infants present with hypotension at a later postnatal age, but the relationship between late onset hypotension (LOH) and BPD has not been evaluated. To evaluate the association between LOH and BPD and to identify pre- and postnatal factors associated with LOH. Prospectively collected data from a cohort of 23-28 weeks gestational age (GA) infants born during years 2005-2015 and alive at day 28 were analyzed. LOH was defined as the receipt of vasopressor treatment during days 8-28. BPD was defined as need for oxygen at 36 weeks postmenstrual age. Late mortality was defined as death after day 28. Of 1,058 infants in the cohort, 90 (9%) had LOH during days 8-28. Infants with LOH had a higher incidence of BPD than normotensive infants (55 vs. 21%, p < 0.001). Multivariate logistic regression analysis (LRA) showed that LOH was associated with an increased risk for BPD (OR 1.87, 95% CI 1.10-3.17). LOH was also associated with an increased risk for late mortality. LRA showed the risk for LOH increased with lower GA, sepsis and patent ductus arteriosus during days 8-28. In this cohort of extremely premature infants, LOH was associated with an increased the risk for BPD. This association could be secondary to underlying factors that predispose to LOH and BPD or to the deleterious effects of LOH or its treatments on the lung. Further investigation is needed to assess causality.
Sections du résumé
BACKGROUND
In extremely premature infants, arterial hypotension in the first days after birth has been associated with an increased risk for bronchopulmonary dysplasia (BPD). Some infants present with hypotension at a later postnatal age, but the relationship between late onset hypotension (LOH) and BPD has not been evaluated.
OBJECTIVE
To evaluate the association between LOH and BPD and to identify pre- and postnatal factors associated with LOH.
METHODS
Prospectively collected data from a cohort of 23-28 weeks gestational age (GA) infants born during years 2005-2015 and alive at day 28 were analyzed. LOH was defined as the receipt of vasopressor treatment during days 8-28. BPD was defined as need for oxygen at 36 weeks postmenstrual age. Late mortality was defined as death after day 28.
RESULTS
Of 1,058 infants in the cohort, 90 (9%) had LOH during days 8-28. Infants with LOH had a higher incidence of BPD than normotensive infants (55 vs. 21%, p < 0.001). Multivariate logistic regression analysis (LRA) showed that LOH was associated with an increased risk for BPD (OR 1.87, 95% CI 1.10-3.17). LOH was also associated with an increased risk for late mortality. LRA showed the risk for LOH increased with lower GA, sepsis and patent ductus arteriosus during days 8-28.
CONCLUSIONS
In this cohort of extremely premature infants, LOH was associated with an increased the risk for BPD. This association could be secondary to underlying factors that predispose to LOH and BPD or to the deleterious effects of LOH or its treatments on the lung. Further investigation is needed to assess causality.
Identifiants
pubmed: 30485857
pii: 000494104
doi: 10.1159/000494104
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
164-168Informations de copyright
© 2018 S. Karger AG, Basel.