Recent short-term and long-term outcomes of massive pulmonary hemorrhage in extremely low birth weight infants: A nationwide cohort study.

INTRODUCTION

To evaluate the short- and long-term outcomes, particularly neurodevelopment, of extremely low birth weight (ELBW) infants with massive pulmonary hemorrhage, in the context of recent improvements in perinatal and neonatal intensive care.

STUDY

DESIGN

Data from the prospective registry of the Korean Neonatal Network of ELBW infants born in 69 hospitals across South Korea between 2014 and 2022 were retrospectively analyzed.

RESULTS

Seven hundred and eight (11.2 %) of 6344 ELBW infants were diagnosed with MPH and divided into survivors at discharge (n = 253, 35.7 %) and in-hospital deaths (n = 455, 64.3 %). The annual incidence of MPH significantly declined from 13.9 % in 2014 to 7.7 % in 2022, and was accompanied by a similar decrease in in-hospital mortality. Surviving infants who experienced MPH had higher rates of in-hospital morbidities. They also showed more adverse neurodevelopmental outcomes than those without MPH. After multivariable adjustment, the risks of cerebral palsy (OR 2.136; 95 % CI 1.253-3.638) and moderate developmental delay on BSID-II/III (OR 2.088; 95 % CI 1.279-3.409) remained significantly higher in MPH survivors.

CONCLUSION

The incidence and in-hospital deaths of massive pulmonary hemorrhage in ELBW infants have decreased in recent years. However, improved survival may be accompanied by increased in-hospital morbidity and adverse neurodevelopmental outcomes, underscoring the need for ongoing monitoring and strategies to mitigate short- and long-term complications in this high-risk population.