Characteristics and outcomes of preterm infants with early pulmonary hypertension.

OBJECTIVE

This study investigates incidence, outcomes and echocardiographic characteristics of preterm infants with early pulmonary hypertension (PH) compared to those without.

STUDY

DESIGN

A prospective observational study of infants born <29 weeks gestation between July 2021-March 2024. Echocardiograms were performed at 24-48 h and 36 weeks postmenstrual age (PMA). Early PH was defined as bidirectional or right-to-left shunt across the ductus.

RESULT: Early PH was identified in 20/166 (12%) infants. These infants had higher mortality than controls (55% vs 11%; P < 0.01). Initial echocardiogram revealed differences in twist(°) (5.1 vs 7.9; P = 0.03), torsion(°/mm) (0.29 vs 0.41; P = 0.04), systolic time(ms) (146 vs 162; P < 0.01) and isovolumic relaxation time(ms) (58 vs 46; P < 0.01), with several persistent abnormalities at 36 weeks PMA.

CONCLUSION

Preterm infants with early PH have higher mortality and distinct echocardiographic profiles, with functional alterations persisting to 36 weeks PMA in survivors. Early identification and targeted management may improve outcomes.