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.