The following is a summary of “Clinical Significance of Early Pulmonary Hypertension in Preterm Infants,” published in the December 2022 issue of Pediatrics by Arjaans, et al.


For a study, researchers sought to describe the various forms of early pulmonary hypertension (PH) in preterm newborns and the relationships between survival and bronchopulmonary dysplasia (BPD).

From June 2016 to March 2019, a prospective cohort study was conducted in a tertiary university medical facility. Infants with gestational age <30 weeks gestation and/or weighed <1,000 g were included. An echocardiographic evaluation for PH was done 3–10 days following delivery. At 36 weeks postmenstrual age, the progression of BPD and death were evaluated.

Of the 104 newborns that were included, 55% had early PH, of which 21% had a persistent PH of the newborn (PPHN), 61% had flow-associated PH, and 18% had PH without a shunt. Only PPHN was linked to poor Apgar scores, low gestational ages, and placental fetal vascular malperfusion. BPD development was connected to both PPHN and flow PH. Early PH was linked to worse survival, which PPHN caused.

Independent of the phenotype of PH, early PH was relatively frequent (55%) in preterm newborns and is linked to the emergence of BPD. PPHN infants had the lowest rates of survival. Early PH manifests as a variety of phenotypes, each with its own etiology, pathophysiology, and long-term aftereffects.

Reference: jpeds.com/article/S0022-3476(22)00700-4/fulltext