Fetal growth restriction and pulmonary hypertension in premature infants with bronchopulmonary dysplasia

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ABSTRACT OBJECTIVE: To identify the association between birth weight (BW)-for-gestational age (GA) and pulmonary hypertension (PHTN) at 36 weeks in infants with moderate–severe


bronchopulmonary dysplasia (BPD). STUDY DESIGN: In this retrospective cohort study, we followed 138 premature infants (⩽28 weeks) with moderate and severe BPD (National Institutes of Health


consensus definition) born at Prentice Women’s Hospital between 2005 and 2009. BW percentiles were calculated using the Fenton growth curve for premature infants. PHTN was determined using a


standardized algorithm of echocardiogram review at 36 weeks. Logistic regression was used to evaluate the associations between BW percentile subgroups and PHTN, taking into account


antenatal and neonatal factors that were related to PHTN. RESULT: PHTN was associated with small BW-for-GA, ranging from thresholds of <10th to <25th percentile (_P_<0.001). These


associations remained significant when comparing BW <25th percentile to the reference group (50 to 89th percentile); after adjustment for GA, gender, multiple gestation, race/ethnicity


(odds ratio (OR)=4.2; 95% confidence interval (CI)=1.5, 12.1); and after further adjustment for maternal vascular disease, intrauterine infection, oligohydramnios and relevant postnatal


factors (OR=5.7; 95% CI=1.5, 21.2). Longitudinal follow-up of this cohort showed a trend toward higher morbidity and death among PHTN infants with BW <25th percentile. CONCLUSION:


BW-for-GA is an important predictor of PHTN in premature infants with moderate–severe BPD. Our findings contribute to the growing evidence supporting fetal mechanisms of later onset


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our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS LONG-TERM IMPACT OF LATE PULMONARY HYPERTENSION REQUIRING MEDICATION IN EXTREMELY PRETERM INFANTS WITH SEVERE


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September 2023 REFERENCES * An HS, Bae EJ, Kim GB, Kwon BS, Beak JS, Kim EK _et al_. Pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. _Korean Circ J_ 2010; 40 (3):


131–136. Article  Google Scholar  * Khemani E, McElhinney DB, Rhein L, Andrade O, Lacro RV, Thomas KC _et al_. Pulmonary artery hypertension in formerly premature infants with


bronchopulmonary dysplasia: clinical features and outcomes in the surfactant era. _Pediatrics_ 2007; 120 (6): 1260–1269. Article  Google Scholar  * Slaughter JL, Pakrashi T, Jones DE, South


AP, Shah TA . Echocardiographic detection of pulmonary hypertension in extremely low birth weight infants with bronchopulmonary dysplasia requiring prolonged positive pressure ventilation.


_J Perinatol_ 2011; 31 (10): 635–640. Article  CAS  Google Scholar  * Mourani PM, Mullen M, Abman SH . Pulmonary hypertension in bronchopulmonary dysplasia. _Prog Pediatr Cardiol_ 2009; 27


(1-2): 43–48. Article  Google Scholar  * Bose C, Van Marter LJ, Laughon M, O’Shea TM, Allred EN, Karna P _et al_. Fetal growth restriction and chronic lung disease among infants born before


the 28th week of gestation. _Pediatrics_ 2009; 124 (3): e450–e458. Article  Google Scholar  * Lal MK, Manktelow BN, Draper ES, Field DJ . Chronic lung disease of prematurity and intrauterine


growth retardation: a population-based study. _Pediatrics_ 2003; 111 (3): 483–487. Article  Google Scholar  * Rozance PJ, Seedorf GJ, Brown A, Roe G, O’Meara MC, Gien J _et al_.


Intrauterine growth restriction decreases pulmonary alveolar and vessel growth and causes pulmonary artery endothelial cell dysfunction _in vitro_ in fetal sheep. _Am J Physiol Lung Cell Mol


Physiol_ 2011; 301 (6): L860–L871. Article  CAS  Google Scholar  * Rueda-Clausen CF, Morton JS, Davidge ST . Effects of hypoxia-induced intrauterine growth restriction on cardiopulmonary


structure and function during adulthood. _Cardiovasc Res_ 2009; 81 (4): 713–722. Article  CAS  Google Scholar  * Bhat R, Salas AA, Foster C, Carlo WA, Ambalavanan N . Prospective analysis of


pulmonary hypertension in extremely low birth weight infants. _Pediatrics_ 2012; 129 (3): e682–e689. Article  Google Scholar  * Ehrenkranz RA, Walsh MC, Vohr BR, Jobe AH, Wright LL,


Fanaroff AA _et al_. Validation of the National Institutes of Health consensus definition of bronchopulmonary dysplasia. _Pediatrics_ 2005; 116 (6): 1353–1360. Article  Google Scholar  *


Denton CP, Cailes JB, Phillips GD, Wells AU, Black CM, Bois RM . Comparison of Doppler echocardiography and right heart catheterization to assess pulmonary hypertension in systemic


sclerosis. _Br J Rheumatol_ 1997; 36 (2): 239–243. Article  CAS  Google Scholar  * Galie N, Torbicki A, Barst R, Dartevelle P, Haworth S, Higenbottam T _et al_. Guidelines on diagnosis and


treatment of pulmonary arterial hypertension. The task force on diagnosis and treatment of pulmonary arterial hypertension of the European Society of Cardiology. _Eur Heart J_ 2004; 25 (24):


2243–2278. Article  Google Scholar  * Porta N, Wax DF, Lestrud SO, Beier JM, Gotteiner NL . Echocardiographic assessment of ventricular dimensions predict degree of pulmonary hypertension


in premature infants with bronchopulmonary dysplasia. _Pediat Res_ 2010 E-PAS2010 3708. * American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 101: ultrasonography


in pregnancy. _Obstet Gynecol_ 2009; 113 (2 Pt 1): 451–461. Google Scholar  * Fenton TR . A new growth chart for preterm babies: Babson and Benda’s chart updated with recent data and a new


format. _BMC Pediatr_ 2003; 3: 13. Article  Google Scholar  * ACOG Committee on Obstetric Practice ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33,


January 2002. American College of Obstetricians and Gynecologists. _Int J Gynaecol Obstet_ 2002; 77 (1): 67–75. Article  Google Scholar  * Papile LA, Burstein J, Burstein R, Koffler H .


Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1500 gm. _J Pediatr_ 1978; 92 (4): 529–534. Article  CAS  Google


Scholar  * Walsh MC, Kliegman RM . Necrotizing enterocolitis: treatment based on staging criteria. _Pediatr Clin North Am_ 1986; 33 (1): 179–201. Article  CAS  Google Scholar  * Barker DJ .


The fetal and infant origins of disease. _Eur J Clin Invest_ 1995; 25 (7): 457–463. Article  CAS  Google Scholar  * Jayet PY, Rimoldi SF, Stuber T, Salmon CS, Hutter D, Rexhaj E _et al_.


Pulmonary and systemic vascular dysfunction in young offspring of mothers with preeclampsia. _Circulation_ 2010; 122 (5): 488–494. Article  Google Scholar  * Kim DH, Kim HS, Choi CW, Kim EK,


Kim BI, Choi JH . Risk factors for pulmonary artery hypertension in preterm infants with moderate or severe bronchopulmonary dysplasia. _Neonatology_ 2012; 101 (1): 40–46. Article  Google


Scholar  * Hoyert DL, Mathews TJ, Menacker F, Strobino DM, Guyer B . Annual summary of vital statistics: 2004. _Pediatrics_ 2006; 117 (1): 168–183. Article  Google Scholar  * Zeitlin J,


Ancel PY, Saurel-Cubizolles MJ, Papiernik E . The relationship between intrauterine growth restriction and preterm delivery: an empirical approach using data from a European case-control


study. _Br J Obstet Gynaecol_ 2000; 107 (6): 750–758. Article  CAS  Google Scholar  * Zeitlin J, El Ayoubi M, Jarreau PH, Draper ES, Blondel B, Kunzel W _et al_. Impact of fetal growth


restriction on mortality and morbidity in a very preterm birth cohort. _J Pediatr_ 2010; 157 (5): 733–9 e1. Article  Google Scholar  * Mourani PM, Sontag MK, Younoszai A, Ivy DD, Abman SH .


Clinical utility of echocardiography for the diagnosis and management of pulmonary vascular disease in young children with chronic lung disease. _Pediatrics_ 2008; 121 (2): 317–325. Article


  Google Scholar  Download references ACKNOWLEDGEMENTS This project was supported by NHLBI Grant K23 HL093302 (PI: Mestan). AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of


Pediatrics, Division of Neonatology, Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, IL, USA J Check, N Porta, R Steinhorn & K K


Mestan * Department of Pediatrics, Division of Cardiology, Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, IL, USA N Gotteiner *


Department of Pediatrics, Mary Ann and J Milburn Smith Child Health Research Program, Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL,


USA X Liu * Department of Obstetrics and Gynecology, Divisions of Maternal Fetal Medicine and Reproductive Biology Research, Northwestern University Feinberg School of Medicine, Chicago, IL,


USA E Su Authors * J Check View author publications You can also search for this author inPubMed Google Scholar * N Gotteiner View author publications You can also search for this author


inPubMed Google Scholar * X Liu View author publications You can also search for this author inPubMed Google Scholar * E Su View author publications You can also search for this author


inPubMed Google Scholar * N Porta View author publications You can also search for this author inPubMed Google Scholar * R Steinhorn View author publications You can also search for this


author inPubMed Google Scholar * K K Mestan View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to K K Mestan. ETHICS


DECLARATIONS COMPETING INTERESTS The authors declare no conflict of interest. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Check, J., Gotteiner, N.,


Liu, X. _et al._ Fetal growth restriction and pulmonary hypertension in premature infants with bronchopulmonary dysplasia. _J Perinatol_ 33, 553–557 (2013).


https://doi.org/10.1038/jp.2012.164 Download citation * Received: 17 April 2012 * Revised: 24 October 2012 * Accepted: 10 December 2012 * Published: 17 January 2013 * Issue Date: July 2013 *


DOI: https://doi.org/10.1038/jp.2012.164 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not


currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * intrauterine growth restriction * small-for-gestational


age * pulmonary vascular disease * preterm birth