151 - Perinatal Risk Factors for Massive Pulmonary Hemorrhage and Related Mortality in Extremely Low Birth Weight Infant

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 151
Publication Number: 151.437

JONG KI JUNG, Department of Pediatrics, Korea University Ansan Hospital, Guro-gu, Seoul-t'ukpyolsi, Republic of Korea; Do Young Kim, Korea university Ansan hospital, Ansansi, Kyonggi-do, Republic of Korea; Ju Sun Heo, Korea University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea; Ji Soo Son, Department of pediatrics, Korea University Ansan Hospital, Seoul, Seoul-t'ukpyolsi, Republic of Korea; Meekyoung Kim, Korea University, Ansan hospital, Ansan, Kyonggi-do, Republic of Korea; Kyu Hee Park, Korea university College of Medicine, Ansan, Kyonggi-do, Republic of Korea; Byung Min Choi, Korea University College of Medicine, Seoul, Seoul-t'ukpyolsi, Republic of Korea; Eun Yeob Kim, Ansan Hospital, Korea University College of Medicine,, Ansan, Kyonggi-do, Republic of Korea; Hye Won Cho, Department of Pediatrics, Korea University Ansan Hospital, Ansan, Kyonggi-do, Republic of Korea; danBee Park, Department of pediatrics, korea university Ansan hospital, Ansan, Kyonggi-do, Republic of Korea; naWon Lee, Department of pediatrics, Korea University Ansan Hosipital, Ansan, Kyonggi-do, Republic of Korea

Presenting Author(s)

JONG KI JUNG, MD (he/him/his)

Resident
Department of Pediatrics, Korea University Ansan Hospital
Ansan-si, Kyonggi-do, Republic of Korea

Background:

Massive pulmonary hemorrhage (MPH) is defined as a sudden onset of hemorrhage within the trachea in conjunction with cardiorespiratory decompensation and a clinical need for increased respiratory support.

Although there are several effective methods of managing pulmonary hemorrhage, MPH is a life-threatening catastrophic event which is associated with a high mortality rate in extremely preterm infants within the first few days of life.

Objective: In this study, we aimed to seek the p</span>reventative measures for MPH and related mortality in the beginning of life, we planned to investigate the perinatal risk factors for MPH and related mortality in extremely low birth weight infants (ELBWIs).

Design/Methods:

This is a prospective cohort study for 5,752 ELBWIs from Korean Neonatal Network database from 2013 to 2020.

To identify significant perinatal risk factors associated with MPH and related mortality, all perinatal factors were included in the univariate and multivariate analyses.

Results:

1. Incidence of MPH was 11.5% (664/5,752) in ELBWIs. The mortality of infants with MPH was 60.2% (400/664), which was significantly higher than that of infants without MPH (21.6%, 1,101/5,088).

2. The MPH group showed significant differences in gestational age, birth weight, multiple gestation, chorioamnionitis, complete antenatal steroid, need for initial resuscitation, body temperature at admission, pH within 1 hour after birth, base excess within 1 hour after birth, use of surfactant, and symptomatic PDA as compared to the non-MPH group.

3. In MPH group, death group showed significant differences in chorioamnionitis, body temperature at admission, and symptomatic PDA as compared to alive group.

4. In multivariate logistic regression analysis adjusted by variant variables, risk factors for MPH were analyzed as multiple gestation (adjusted odds ration [aOR] = 1.433), surfactant use (aOR = 4.545), and symptomatic PDA (aOR = 1.656).

Conclusion(s): In ELBWIs, nasal continuous positive airway pressure and selective pulmonary surfactant administration, to reduce routine use of pulmonary surfactant, and early targeted pharmacological treatment to reduce the symptomatic PDA can help reduce the incidence of MPH.