Neonatal outcomes of preterm infants with pulmonary hypertension: clustering based on prenatal risk factors.

Autor: Bae SP; Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.; Department of Pediatrics, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea., Kim SS; Department of Pediatrics, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea. kimss@schmc.ac.kr.; Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea. kimss@schmc.ac.kr., Yun J; Department of Pediatrics, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Republic of Korea., Lee H; Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.; Department of Pediatrics, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea., Hahn WH; Department of Pediatrics, Inha University Hospital, Incheon, Republic of Korea., Park S; Department of Biostatistics, Academic Research Office, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.; Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea.
Jazyk: angličtina
Zdroj: Pediatric research [Pediatr Res] 2024 Oct; Vol. 96 (5), pp. 1251-1257. Date of Electronic Publication: 2024 May 11.
DOI: 10.1038/s41390-024-03232-1
Abstrakt: Background: To investigate association of prenatal risk factors and neonatal outcomes of preterm infants with pulmonary hypertension (PH).
Methods: A prospective cohort study of very-low-birth-weight infants born at 22-29 weeks' gestation who received PH-specific treatment during hospitalization. Infants were classified using a two-step cluster analysis based on gestational age (GA), small-for-gestational-age (SGA), exposure to antenatal corticosteroids (ACS), histologic chorioamnionitis (HCA), and oligohydramnios.
Results: Among 910 infants, six clusters were identified: cluster A (HCA, n = 240), cluster B (oligohydramnios, n = 79), cluster C (SGA, n = 74), cluster D (no-ACS, n = 109), cluster E (no dominant parameter, n = 287), and cluster F (HCA and oligohydroamnios, n = 121). Cluster A was used as a reference group for comparisons among clusters. Compared to cluster A, cluster C (aHR: 1.63 [95% CI: 1.17-2.26]) had higher risk of overall in-hospital mortality. Clusters B (aHR: 1.52 [95% CI: 1.09-2.11]), D (aHR: 1.71 [95% CI: 1.28-2.30]), and F (aHR: 1.51 [95% CI: 1.12-2.03]) had higher risks of receiving PH-specific treatment within the first week of birth compared to cluster A.
Conclusion: These findings may provide a better understanding of prenatal risk factors contributing to the development of PH.
Impact: Pulmonary hypertension (PH), presenting as hypoxic respiratory failure, has complex etiologies in preterm infants. Although multifactorial risks for the development of PH in preterm infants are known, few studies have classified infants with similar etiologies for PH. Each cluster has distinct patterns of prenatal condition and neonatal outcome.
(© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)
Databáze: MEDLINE
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