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Utility of echocardiography in predicting mortality in infants with severe bronchopulmonary dysplasia

Journal of Perinatology volume 40, pages 149–156 (2020)Cite this article

Subjects

Abstract

Objective

To determine the relationship between interventricular septal position (SP) and right ventricular systolic pressure (RVSP) and mortality in infants with severe BPD (sBPD).

Study design

Infants with sBPD in the Children’s Hospitals Neonatal Database who had echocardiograms 34–44 weeks’ postmenstrual age (PMA) were included. SP and RVSP were categorized normal, abnormal (flattened/bowed SP or RVSP > 40 mmHg) or missing.

Results

Of 1157 infants, 115 infants (10%) died. Abnormal SP or RVSP increased mortality (SP 19% vs. 8% normal/missing, RVSP 20% vs. 9% normal/missing, both p < 0.01) in unadjusted and multivariable models, adjusted for significant covariates (SP OR 1.9, 95% CI 1.2–3.0; RVSP OR 2.2, 95% CI 1.1–4.7). Abnormal parameters had high specificity (SP 82%; RVSP 94%), and negative predictive value (SP 94%, NPV 91%) for mortality.

Conclusions

Abnormal SP or RVSP is independently associated with mortality in sBPD infants. Negative predictive values distinguish infants most likely to survive.

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Code availability

The computer code used to generate statistical analyses may be made available upon request to the Children’s Hospitals Neonatal Consortium.

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Funding

The Children’s Hospitals Neonatal Consortium (501-c3 organization) supported the statistical analyses presented in this manuscript.

Author information

Author notes

  1. These authors contributed equally: Shilpa Vyas-Read, Erica M. Wymore

Authors and Affiliations

  1. Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA

    Shilpa Vyas-Read

  2. Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA

    Erica M. Wymore & Theresa R. Grover

  3. Children’s Hospital Association, Lenexa, KS, USA

    Isabella Zaniletti

  4. Ann and Robert H. Lurie Children’s Hospital of Chicago and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Karna Murthy & Nicolas F. M. Porta

  5. Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Michael A. Padula & Huayan Zhang

  6. Children’s Mercy Hospital, University of Missouri, Kansas City, MO, USA

    William E. Truog

  7. Riley Hospital for Children, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

    William A. Engle

  8. University of Texas Southwestern Medical Center, Dallas, TX, USA

    Rashmin C. Savani & Sushmita Yallapragada

  9. Nationwide Children’s Hospital, The Ohio State University, Columbus, OH, USA

    J. Wells Logan & Leif D. Nelin

  10. Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, Cincinnati, OH, USA

    Erik B. Hysinger

  11. Children’s Hospital of Michigan, Wayne State University, Detroit, MI, USA

    Girija Natarajan

  12. Department of Pediatrics, Division of Newborn Medicine, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    Karin P. Potoka

  13. Seattle Children’s Hospital, University of Washington, Seattle, WA, USA

    Robert DiGeronimo

  14. Children’s Hospital of Wisconsin, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA

    Joanne M. Lagatta

Authors
  1. Shilpa Vyas-Read
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  2. Erica M. Wymore
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  3. Isabella Zaniletti
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  4. Karna Murthy
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  5. Michael A. Padula
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  6. William E. Truog
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  7. William A. Engle
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  8. Rashmin C. Savani
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  9. Sushmita Yallapragada
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  10. J. Wells Logan
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  11. Huayan Zhang
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  12. Erik B. Hysinger
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  13. Theresa R. Grover
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  14. Girija Natarajan
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  15. Leif D. Nelin
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  16. Nicolas F. M. Porta
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  17. Karin P. Potoka
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  18. Robert DiGeronimo
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  19. Joanne M. Lagatta
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Consortia

on behalf of the Children’s Hospitals Neonatal Consortium Severe BPD Focus Group

Contributions

SV-R, EMW, KM, JML: Research question and design, data analysis and interpretation, draft preparation, editing, and revision of the manuscript. IZ: Statistical analysis of the manuscript. MAP, WET, WAE, RCS, SY, JWL, HZ, EBH, TRG, GN, LDN, NFMP, KPP, RD: Data interpretation, editing and revision of the manuscript.

Corresponding author

Correspondence to Shilpa Vyas-Read.

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Vyas-Read, S., Wymore, E.M., Zaniletti, I. et al. Utility of echocardiography in predicting mortality in infants with severe bronchopulmonary dysplasia. J Perinatol 40, 149–156 (2020). https://doi.org/10.1038/s41372-019-0508-5

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