Prevalence, risk factors and outcomes associated with pulmonary hemorrhage in newborns

Ferreira, Cristina Helena Faleiros; Carmona, Fábio; Martinez, Francisco Eulógio

doi:10.1016/j.jped.2013.12.008

Cited by 41 publications

(21 citation statements)

References 24 publications

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“…In our study, the incidence of PH was 7.1% in VLBW infants, while it was as high as 16.9% in extremely low BW infants. Previous literatures found that the incidence of PH was 11-18.8% in extremely low BW infants (5,13). Ahmad et al (10) reported that the incidence of PH increased with decreasing gestational age.…”

Section: Discussionmentioning

confidence: 96%

Association between pulmonary hemorrhage and CPAP failure in very preterm infants

Wang

Zhao

et al. 2022

Front. Pediatr.

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BackgroundPulmonary hemorrhage (PH) in neonates is a life-threatening respiratory complication. We aimed to analyze the perinatal risk factors and morbidity with PH among very preterm infants in a large multicenter study.MethodsThis was a multicenter case–control study based on a prospective cohort. Participants included 3,680 in-born infants with a gestational age at 24–32 weeks (birth weight <1,500 g) who were admitted between January 1, 2019, and October 31, 2021. All infants were divided into two groups, namely, the PH and no-PH groups, at a ratio of 1:2 according to the following factors: gestational age (GA), birth weight (BW), and the Score for Neonatal Acute Physiology with Perinatal extension II (SNAPPE II). Perinatal factors and outcomes were compared between the two groups by logistic regression analyses.ResultsA total of 3,680 infants were included in the study, and the number of identified cases of PH was 262 (7.1%). The incidence was 16.9% (136/806) for neonates with extremely low BW (BW < 1,000 g) infants. The multivariate analysis showed that CPAP failure (OR 2.83, 95% CI 1.57, 5.08) was significantly associated with PH. PH was associated with a high likelihood of death (OR 3.81, 95% CI 2.67, 5.43) and bronchopulmonary dysplasia (BPD) (≥grade II) (OR 1.58, 95% CI 1.00, 2.48).ConclusionsIn this multicenter case–control study based on a prospective cohort, PH to be common among VLBW infants. PH is associated with significant morbidity and mortality, and perinatal management, especially CPAP failure. Respiratory management strategies to decrease the risk of PH should be optimized.

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Section: Discussionmentioning

confidence: 96%

Association between pulmonary hemorrhage and CPAP failure in very preterm infants

Wang

Zhao

et al. 2022

Front. Pediatr.

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“…Massive pulmonary hemorrhage is a life-threatening condition that, according to current literature, complicates hospital course in 3%-5% of preterm infants and generally occurs in 1-12 per 1000 live births, with the rate increasing to 50 per 1000 live births in the groups at risk such as prematurity and severe illnesses [1][2][3] . In our region, we found the incidence of MPH to be 1.91% of total premature births, 4.35% of NICU treated preterm neonates, and 7.44% of those requiring mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

“…In studies from the 1990s, MPH occurred in both preterm and full-term neonates, however, in preterm infants it developed later and was associated with a higher mortality rate than in full-term infants 11,12 . Recent major studies have just highlighted lower gestational age and lower birth weight as the strongest risk factors for the development of MPH 2,3 .…”

Section: Discussionmentioning

confidence: 99%

“…Older papers have reported MPH in both preterm and full-term neonates, with a higher mortality rate in preterm infants, and usually related to perinatal asphyxia, surfactant deficiency, and some serious illnesses 1 . Currently, it is more often described in preterm ventilated neonates, with different incidence reports [1][2][3] . Typical presentation is dramatic and rapid deterioration that starts with reddish foamy discharge in the endotracheal tube or mouth.…”

Section: Introductionmentioning

confidence: 99%

“…Regarding prognosis, there are controversial data on further development; some studies showed no impact 10 , whereas others demonstrated it to carry an increased risk of neurodevelopmental disorders 11 . Regarding short-term outcome, studies report a mortality rate of 40% to 60% 2,8,10 .…”

Section: Introductionmentioning

confidence: 99%

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Short-Term Outcome of Massive Pulmonary Hemorrhage in Preterm Infants in Tuzla Canton

Hadžić

Zulić

Salkanović-Delibegović

et al. 2021

ACC

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Massive pulmonary hemorrhage (MPH) in neonates is a severe condition followed by many complications and associated with a high mortality rate. The aim of this study was to present the incidence, possible risk factors, and short-term outcome of neonatal MPH in Tuzla Canton. We retrospectively analyzed data on neonates with MPH from January 2015 to December 2017. On statistical analysis, standard methods of descriptive statistics were used. During the three-year study period, 16 neonates developed MPH, 5 (31.25%) male and 11 (68.75%) female. Their mean gestational age was 29.48±2.21 weeks and mean birth weight 1276.69±387.65 grams. Seven (43.75%) neonates survived and 9 (56.25%) died. Significant differences between the two outcome groups (survivors/died) were found in gestational age, birth weight, birth length, 5-minute Apgar score, and length of treatment at the Neonatal Intensive Care Unit. In Tuzla Canton, MPH occurred mainly in preterm neonates requiring mechanical ventilation, with the incidence of 1.91% of total premature births. The short-term outcome was uncertain, with a high mortality rate of 56.25%. Lower gestational age, lower birth weight, lower birth length and lower 5-minute Apgar score were confirmed as risk factors for poor short-term outcome.

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Association of vitamin D status at birth with pulmonary disease morbidity in very preterm infants

Zhang

Luo

et al. 2020

Pediatric Pulmonology

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Objective We aimed to assess whether serum 25‐hydroxyvitamin D (25(OH)D) levels at birth are associated with pulmonary disease morbidities in very preterm infants. Methods This prospective cohort analysis included 93 infants born before 32 weeks of gestation in the Second Xiangya Hospital of Central South University between March 2016 and February 2017. Participants were classified into three groups according to their 25(OH)D levels at birth. The groups were compared in terms of demographic variables and pulmonary disease morbidities. Results The mean serum 25(OH)D level at birth was 35.7 ± 19.1 nmol/L, and 38 (40.9%), 31 (33.3%), and 24 (25.8%) infants had 25(OH)D levels of less than 25 nmol/L, 25–50 nmol/L, and more than or equal to 50 nmol/L, respectively. There was a statistically significant difference in neonatal respiratory distress syndrome (RDS) rates among the three groups (43.6% vs. 35.9% vs. 20.5%, p = .029). The rates of bronchopulmonary dysplasia, apnea, respiratory failure, persistent pulmonary hypertension, and pulmonary hemorrhage did not differ significantly among the groups. Logistic analysis, adjusted for gestational age and birth weight, showed that a low serum 25(OH)D level (<50 nmol/L) was a risk factor for RDS (odds ratio, 0.195; p = .017). Conclusion There was a high prevalence of low 25(OH)D levels (<50 nmol/L) and an association between vitamin D status and RDS in very preterm infants. However, more research on this association is required.

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Prevalence, risk factors and outcomes associated with pulmonary hemorrhage in newborns

Abstract: pulmonary hemorrhage is more prevalent in premature newborns, and is associated with intubation in the delivery room and previous use of blood components, leading to high mortality and worse clinical evolution.

Cited by 41 publications

References 24 publications

Association between pulmonary hemorrhage and CPAP failure in very preterm infants

Association between pulmonary hemorrhage and CPAP failure in very preterm infants

Short-Term Outcome of Massive Pulmonary Hemorrhage in Preterm Infants in Tuzla Canton

Association of vitamin D status at birth with pulmonary disease morbidity in very preterm infants

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