Mehler K, et al. - In a study population comprising extremely low birthweight (ELBW) infants, researchers intended to characterize risk factors for pulmonary hypertension (PH) and to describe the timing of onset of the disease by setting up a screening program. They concluded that for detecting infants with PH, an echocardiographic screening program may be helpful. They recommended to examine all ELBW infants irrespective of the presence of bronchopulmonary dysplasia (BPD) and to continue examinations after discharge.

Methods

• This study included ELBW infants treated at the Department of Neonatology (level III neonatal intensive care unit at the University of Cologne Medical Centre, Germany) between January 2010 and March 2015.
• Using echocardiography, infants were screening for PH, either before discharge or if BPD was diagnosed.  
• After discharge, infants had at least 1 echocardiographic scan.
• Study participants were assessed for survival with PH, age at diagnosis of PH, and risk factors associated with PH.

Results

• PH was found in 34/188 (18%) infants, of these, 14 (41%) were identified after discharge.
• According to data, another 11 (32%) were diagnosed with PH without suffering from moderate or severe BPD.
• Moderate (odds ratio, OR 4 [2-8]) or severe BPD (OR 13 [2-71]), prolonged rupture of membranes >7 days (OR 5 [1-19]), and birthweight below the 3rd percentile (OR 3 [1-9]) were identified as the risk factors for diagnosis of PH.
• Sildenafil (2.0 mg/kg/day) was used to treat all infants with PH before discharge and 50% diagnosed after discharge.
• After a median duration of 13 months (IQR 8-20), resolution of PH and discontinuation of sildenafil in all patients was reported.