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Increased risk of pulmonary hypertension following premature birth
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Pediatrics department, Östersund Hospital, Östersund, Sweden.
2019 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 19, no 1, article id 288Article in journal (Refereed) Published
Abstract [en]

Background: Pulmonary hypertension (PAH) among children and adults has been linked to premature birth, even after adjustments for known risk factors such as congenital heart disease and chronic lung disease. The aim of this population-based registry study was to assess the risk of PAH following exposure to premature birth and other factors in the decades when modern neonatal care was introduced and survival rates increased.

Methods: Data on pulmonary hypertension and perinatal factors were retrieved from population-based governmental and national quality registers. Cases were adults and children over five years of age with pulmonary hypertension born from 1973 to 2010 and individually matched to six controls by birth year and delivery hospital. Conditional multiple logistic regression was performed to assess the risk of pulmonary hypertension following premature birth and to adjust for known confounding factors for the total study population and for time of birth, grouped into five-year intervals.

Results: In total, 128 cases and 768 controls were included in the study group. Preterm birth was over three times more common among cases (21%) than among controls (6%). The overall adjusted risk of pulmonary hypertension was associated with premature birth, OR = 4.48 (95% CI; 2.10–9.53). Maternal hypertension, several neonatal risk factors and female gender were independently associated with PAH when potential confounders were taken into account. For each five-year period, the risk of PAH following premature birth increased several times for children born in the 2000s and later, OR = 17.08 (95% CI 5.60–52.14).

Conclusions: Preterm birth, along with other factors, significantly contributes to PAH. PAH following premature birth has increased over the last few decades. Our study indicates that new, yet unknown factors may play a role in the risk of preterm-born infants developing PAH later in life.

Place, publisher, year, edition, pages
2019. Vol. 19, no 1, article id 288
Keywords [en]
Bronchopulmonary dysplasia, Lung disease, Preterm birth, Pulmonary hypertension
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:umu:diva-165212DOI: 10.1186/s12887-019-1665-6ISI: 000481770500002PubMedID: 31421674Scopus ID: 2-s2.0-85070941509OAI: oai:DiVA.org:umu-165212DiVA, id: diva2:1370403
Available from: 2019-11-15 Created: 2019-11-15 Last updated: 2019-11-15Bibliographically approved

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