103 - Characteristics of infants with severe bronchopulmonary dysplasia and pulmonary vein stenosis

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 103
Publication Number: 103.426

Erica McArthur, Emory University School of Medicine, Atlanta, GA, United States; Shannon Hamrick, Emory University School of Medicine, Atlanta, GA, United States; James Kuo, Emory University School of Medicine, Decatur, GA, United States; Brenda Anani, Children's Healthcare of Atlanta, Lawrenceville,, GA, United States; Zhulin He, Emory University School of Medicine, Atlanta, GA, United States; Shilpa Vyas-Read, Emory University, Atlanta, GA, United States

Presenting Author(s)

Erica McArthur, MD (she/her/hers)

Neonatology Fellow
Emory University School of Medicine
Atlanta, Georgia, United States

Background: Pulmonary vein stenosis (PVS) can be present in preterm infants with severe bronchopulmonary dysplasia (sBPD). Severe, multivessel PVS has a high rate of morbidity and mortality. Several studies have evaluated pediatric risk factors for PVS, but the neonatal characteristics associated with PVS in infants with sBPD have not been well defined.

Objective: Determine neonatal factors associated with PVS among infants with sBPD in a referral-based children’s hospital.

Design/Methods: Infants born at < 32 weeks’ gestation were identified through the Children’s Hospital Neonatal Consortium database and pulmonary vein stenosis registry at Children’s Healthcare of Atlanta. All infants with sBPD and PVS from 2010-July 1, 2022 were included. Severe BPD was defined as respiratory support of >2L of flow at 36 weeks’ postmenstrual age (PMA), and PVS was diagnosed by echocardiography or cardiac catheterization. Means with standard deviations or medians with interquartile ranges of demographic variables were determined as appropriate.

Results: Of the 11 infants in our cohort, mean gestational age was 24.4 weeks (+1.4 weeks), mean birthweight was 628 grams (+143.5 grams), median length of stay was 137 days (IQR 81 days), and over half of infants were female (54.4%) (Table 1a). Median age at diagnosis was 94 days (IQR 75) and 6 infants were diagnosed at 3-6 months old. All infants had pulmonary hypertension, many had patent ductus arteriosus (63.6%), and the majority had abdominal surgery prior to PVS diagnosis (72.7% with either spontaneous intestinal perforation or necrotizing enterocolitis). At 36 weeks’ PMA many infants required conventional ventilation (72.7%) (Table 1b). Most infants were diagnosed with PVS by echocardiogram (90.9%) and had one vein stenosed (72.7%) (Table 1c).

Conclusion(s): Among infants with sBPD, screening efforts should focus particularly on those who are peri-viable at birth, have Grade 3 BPD, or have concomitant PH and/or abdominal surgery. A case-control study of infants with sBPD with and without PVS is underway and will further delineate neonatal risk factors. Elucidating clinical characteristics that predispose infants with sBPD to PVS will guide future screening efforts and will be important for counseling families.