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Objective: Characterisation of oxygen saturation (SpO)-related predictors that correspond with both bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) development and survival status in infants with BPD-PH may improve patient outcomes. This investigation assessed whether (1) infants with BPD-PH compared with infants with BPD alone, and (2) BPD-PH non-survivors compared with BPD-PH survivors would (a) achieve lower SpO distributions, (b) have a higher fraction of inspired oxygen (FiO) exposure and (c) have a higher oxygen saturation index (OSI).
Design: Case-control study between infants with BPD-PH (cases) and BPD alone (controls) and by survival status within cases.
Setting: Single-centre study in the USA.
Patients: Infants born at <29 weeks' gestation and on respiratory support at 36 weeks' postmenstrual age.
Exposures: FiO exposure, SpO distributions and OSI were analysed over the week preceding BPD-PH diagnosis.
Main Outcomes And Measures: BPD-PH, BPD alone and survival status in infants with BPD-PH.
Results: 40 infants with BPD-PH were compared with 40 infants with BPD alone. Infants who developed BPD-PH achieved lower SpO compared with infants with BPD (p<0.001), were exposed to a higher FiO (0.50 vs 0.34; p=0.02) and had a higher OSI (4.3 vs 2.6; p=0.03). Compared with survivors, infants with BPD-PH who died achieved a lower SpO (p<0.001) and were exposed to a higher FiO (0.70 vs 0.42; p=0.049).
Conclusions: SpO-related predictors differed between infants with BPD-PH and BPD alone and among infants with BPD-PH by survival status. The OSI may provide a non-invasive predictor for BPD-PH in preterm infants.
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http://dx.doi.org/10.1136/archdischild-2024-327014 | DOI Listing |
Arch Dis Child Fetal Neonatal Ed
September 2025
Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Objective: Bronchopulmonary dysplasia (BPD) associated pulmonary hypertension (BPD-PH) is the most severe endotype of BPD; there is insufficient evidence to support the optimal screening strategy in at-risk infants. We hypothesised that serial echocardiography throughout hospitalisation would improve PH detection with increased negative predictive value (NPV) beyond 36 week's postmenstrual age (PMA).
Study Design: This was a single centre cohort study conducted between 2017 and 2023.
Pediatr Pulmonol
September 2025
Department of Neonatology, La Paz University Hospital, Madrid, Spain.
Objective: To describe national patterns in the screening, diagnosis, and clinical management of bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) in Spanish neonatal intensive care units (NICUs) and assess the need for standardized screening and management protocols and unified follow-up strategies.
Methods: A 20-question electronic survey was distributed to all Level III NICUs in the Spanish public health system to evaluate practices in BPD-PH screening, diagnosis, and clinical management. Results were analyzed globally and by NICU level (IIIB vs.
J Matern Fetal Neonatal Med
December 2025
Neonatal Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
Objectives: To describe the outcome and identify the risk factors associated with death in very premature infants with bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH).
Methods: A single-center retrospective study was conducted in infants with a gestational age <32 weeks and/or birth weight <1500 g who developed BPD associated PH (BPD-PH) at Children's Hospital of Zhejiang University School of Medicine between January 2011 and December 2023. Kaplan-Meier's estimate and Cox regression were performed for survival analysis.
Nat Commun
May 2025
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
Lung injury in preterm infants leads to structural and functional respiratory deficits, with a risk for bronchopulmonary dysplasia (BPD) that in its most severe form is accompanied by pulmonary hypertension (PH). To identify potential cellular and molecular drivers of BPD in humans, we performed single-cell RNA sequencing of preterm infant lungs with evolving BPD and BPD + PH compared to term infants. Examination of endothelial cells reveals a unique, aberrant capillary cell-state in BPD + PH defined by ANKRD1 expression.
View Article and Find Full Text PDFPediatr Res
May 2025
Division of Neonatology, MosaKids Children's Hospital, Maastricht University Medical Centre (MUMC + ), Research Institute for Oncology and Reproduction (GROW), Maastricht University, Maastricht, The Netherlands.
Background: Bronchopulmonary dysplasia (BPD) is generally considered to be more frequent in males than in females. We conducted a Bayesian model-averaged (BMA) meta-analysis of studies addressing sex differences in the risk of developing different severities of BPD and BPD-associated pulmonary hypertension (BPD-PH).
Methods: We used BMA to calculate Bayes factors (BFs).