Fetal growth restriction and pulmonary hypertension in premature infants with bronchopulmonary dysplasia.
Fetal growth restriction and pulmonary hypertension in premature infants with bronchopulmonary dysplasia.
复制标题
胎儿生长限制和支气管肺发育不良的早产儿的肺部高血压。
DOI：
10.1038/jp.2012.164
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发表时间：
2013-07
影响因子：
2.9
通讯作者：
Mestan, K. K.
中科院分区：
文献类型：
--
作者：
Check, J.;Gotteiner, N.;Liu, X.;Su, E.;Porta, N.;Steinhorn, R.;Mestan, K. K.
关键词：
目的：探讨中重度支气管肺发育不良(BPD)患儿36周出生体重(BW)、胎龄(GA)与肺动脉高压(PHTN)的关系。在这项回顾性队列研究中，我们跟踪了2005年至2009年在普伦蒂斯妇女医院出生的138名中重度BPD(≤共识定义)早产儿(NIH 28周)。采用Fenton生长曲线计算早产儿体重百分位数。36周时采用超声心动图复查的标准化算法测定PHTN。考虑到与PHTN相关的产前和新生儿因素，采用Logistic回归分析来评估体重百分位数亚组与PHTN之间的相关性。PHTN与GA的小体重有关，阈值从第10个百分位数到第25个百分位数(P<；0.001)。当比较体重和体重第25百分位数与参照组(50-89百分位数)时，调整了GA、性别、多胎、种族/民族(OR=4.2；95%CI=1.5，12.1)，以及进一步调整母体血管疾病、宫内感染、羊水过少和相关的出生后因素(OR=5.7；95%CI=1.5，21.2)后，这些相关性仍然显著。这一队列的纵向随访显示，在出生体重为25%的PHTN婴儿中，有更高的发病率和死亡率。BW-for-GA是预测中、重度BPD早产儿PHTN的重要指标。我们的发现有助于越来越多的证据支持胎儿迟发性肺血管疾病的发病机制。
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). In this retrospective cohort study, we followed 138 premature infants (≤28wks) with moderate and severe BPD (NIH 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. 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 (50–89th percentile); after adjustment for GA, gender, multiple gestation, race/ethnicity (OR=4.2; 95% 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 towards higher morbidity and death among PHTN infants with BW <25th percentile. 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 pulmonary vascular disease.
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影响因子：
8
作者：
Lal, MK;Manktelow, BN;Field, DJ
通讯作者：
Field, DJ
影响因子：
2.5
作者：
Kim, Do-Hyun;Kim, Han-Suk;Choi, Jung-Hwan
通讯作者：
Choi, Jung-Hwan
DOI：
10.1152/ajplung.00197.2011
发表时间：
2011-12-01
影响因子：
4.9
作者：
Rozance, Paul J.;Seedorf, Gregory J.;Abman, Steven H.
通讯作者：
Abman, Steven H.
影响因子：
5.1
作者：
PAPILE, LA;BURSTEIN, J;KOFFLER, H
通讯作者：
KOFFLER, H
影响因子：
8
作者：
Khemani, Ekta;McElhinney, Doff B.;Mullen, Mary P.
通讯作者：
Mullen, Mary P.