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Bronchopulmonary dysplasia and pulmonary hypertension: a meta-analysis

Journal of Perinatology volume 37, pages 414–419 (2017)Cite this article

Subjects

Abstract

Objective:

Pulmonary hypertension (PH) is a complication of bronchopulmonary dysplasia (BPD) but the true impact of PH in patients with BPD remains unclear. We sought to systematically review and meta-analyze incidence of PH in BPD and compare clinical outcomes of BPD patients with PH to those without PH in preterm infants.

Study Design:

Medline, Embase, PsychINFO and CINAHL were searched from January 2000 through December 2015. Cohort, case–control and randomized studies were included. Case-reports, case-series and letters to editors and studies with high risk of bias were excluded. Study design, inclusion/exclusion criteria, diagnostic criteria for BPD and PH and outcomes were extracted independently by two co-authors.

Results:

The pooled incidence of PH in patients with BPD (any severity) was 17% (95% confidence interval (CI) 12 to 21; 7 studies) and 24% (95% CI 17 to 30; 9 studies) in moderate-severe BPD. Patients with BPD have higher unadjusted odds of developing PH compared to those without BPD (odds ratio (OR) 3.00; 95% CI 1.18 to 7.66; 4 studies). Patients with BPD and PH were at higher odds of mortality (OR 5.29; 95% CI 2.07 to 13.56; 3 studies) compared with BPD without PH, but there was no significant difference in duration of initial hospitalization, duration of supplemental oxygen requirement or need for home oxygen. No studies included in this review reported on long-term pulmonary or neurodevelopmental outcomes.

Conclusions:

PH occurs in one out of 4 to 5 preterm neonates with BPD. Patients with BPD and PH may have higher odds of mortality; however, there is urgent need for high quality studies that control for confounders and provide data on long-term outcomes.

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Acknowledgements

Study registration and registration number: PROSPERO CRD42016042104.

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Authors and Affiliations

  1. Department of Pediatrics, McMaster University, Hamilton, ON, Canada

    G Al-Ghanem, L Banfield, S el Helou, C Fusch & A Mukerji

  2. Department of Pediatrics, University of Toronto, Toronto, ON, Canada

    P Shah

  3. Department of Pediatrics, University of Calgary, Calgary, AB, Canada

    S Thomas

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  1. G Al-Ghanem
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Corresponding author

Correspondence to A Mukerji.

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The authors declare no conflict of interest.

Additional information

Data from this research were presented at Pediatric Academic Societies, San Diego 2016.

Supplementary Information accompanies the paper on the Journal of Perinatology website

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Al-Ghanem, G., Shah, P., Thomas, S. et al. Bronchopulmonary dysplasia and pulmonary hypertension: a meta-analysis. J Perinatol 37, 414–419 (2017). https://doi.org/10.1038/jp.2016.250

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