Predictors of bronchopulmonary dysplasia and pulmonary hypertension in newborn children

Introduction: Infants with bronchopulmonary dysplasia (BPD) are at high risk of developing cardiovascular sequelae in the form of pulmonary hypertension (PH) which significantly increases morbidity and mortality. The aim of this study was to evaluate the incidence of BPD, to identify characteristics associated with BPD and to identify characteristics associated with PH in infants with BPD. Material and methods: A retrospective study was performed. Data were obtained from a regional neonatal database and by reviewing medical records of infants admitted during the 2002-2010 period. A total of 400 infants with a birth weight (BW) < 1,500 g were identified. Eight were excluded and 74 infants met the criteria for BPD. A total of 17 infants with BPD had PH. Results: We found that the incidence of BPD at the Neonatal Department at Hvidovre Hospital between January 2002 and December 2010 was 18%. Infants with BPD differed significantly from infants without BPD with regard to the following characteristics: Infants with BPD more frequently had a lower gestational age and BW, intubation at birth, mechanical ventilation within 24 hours of birth, a lower Apgar score at one minute and five minutes. The incidence of PH was 23% among infants with BPD. Furthermore, we found a significantly larger frequency of intubation at birth, postnatal infection, longer duration of continuous positive airway pressure treatment and use of oxygen therapy among infants with PH and BPD than among the remaining infants. Conclusion: The incidence of BPD was 18%. Low gestational age was found to be the most important factor associated with development of BPD. Among BPD infants, postnatal infection was significantly associated with PH. Further prospective studies including routine echocardiography are needed to evaluate risk factors for PH.