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Association of the respiratory severity score with bronchopulmonary dysplasia-associated pulmonary hypertension in infants born extremely preterm

Journal of Perinatology volume 44, pages 294–300 (2024)Cite this article

Subjects

Abstract

Objective

To test the hypothesis that elevations in the respiratory severity score (RSS) are associated with increased probability of bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH).

Study design

Retrospective cohort study of infants born extremely preterm admitted to a BPD center between 2010 and 2018. Echocardiograms obtained ≥ 36 weeks’ post-menstrual age (PMA) were independently adjudicated by two blinded cardiologists to determine the presence/absence of BPD-PH. Multivariable logistic regression estimated the association between RSS and BPD-PH.

Result

BPD-PH was observed in 68/223 (36%) of subjects. The median RSS at time of echocardiography was 3.04 (Range 0–18.3). A one-point increase in the RSS was associated with BPD-PH, aOR 1.3 (95% CI 1.2–1.4), after adjustment for gestational age and PMA at time of echocardiography.

Conclusion

Elevations in the RSS were associated with a greater probability of BPD-PH. Prospective studies are needed to determine the validity and performance of RSS as a clinical susceptibility/risk biomarker for BPD-PH.

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Fig. 1
Fig. 2: Distribution of timing of echocardiography in the cohort, stratified by bronchopulmonary dysplasia associated pulmonary hypertension (BPD-PH) status at the time of assessment.
Fig. 3: The estimated probability of BPD-PH increases with continuous increases in the RSS.

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Data availability

De-identified data that support the findings of this study are available upon request from the corresponding author, MJK.

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Funding

The project described was supported by pilot funding from Award Number UL1TR002733 from the National Center For Advancing Translational Sciences (MJK). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center For Advancing Translational Sciences or the National Institutes of Health. Additional support provided by the Ohio Perinatal Research Network at the Abigail Wexner Research Institute at Nationwide Children’s Hospital.

Author information

Authors and Affiliations

  1. Ohio Perinatal Research Network, Nationwide Children’s Hospital, Columbus, OH, USA

    Lindsey Beer, Brian K. Rivera, Waceys Jama, Jonathan L. Slaughter, Carl H. Backes, Sara Conroy & Matthew J. Kielt

  2. Division of Neonatology, Nationwide Children’s Hospital, Columbus, OH, USA

    Lindsey Beer, Jonathan L. Slaughter, Carl H. Backes & Matthew J. Kielt

  3. Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    Brian K. Rivera, Jonathan L. Slaughter & Carl H. Backes

  4. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA

    Jonathan L. Slaughter & Carl H. Backes

  5. The Heart Center, Nationwide Children’s Hospital, Columbus, OH, USA

    Carl H. Backes

  6. Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus, OH, USA

    Sara Conroy

  7. Biostatistics Resource at Nationwide Children’s Hospital, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    Sara Conroy

  8. Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children’s Hospital, Columbus, OH, USA

    Matthew J. Kielt

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Contributions

LB conceptualized and designed the study, collected, analyzed and interpreted the data, drafted the initial manuscript and reviewed and revised the final manuscript; BKR contributed to collection, analysis and interpretation of the data, and reviewed and revised the final manuscript. WJ contributed to analysis and interpretation of data and reviewed and revised the final manuscript. JLS contributed to analysis and interpretation of data, contributed to drafting of the initial manuscript, reviewed the manuscript for important intellectual content and reviewed and revised the final manuscript. CHB contributed to the design of the study, read and interpreted clinical echocardiograms, reviewed the manuscript for important intellectual content, and reviewed and revised the final manuscript. SC contributed to the design of the study, analyzed and interpreted the data, reviewed the manuscript for important intellectual content, and reviewed and revised the final manuscript. MJK conceptualized and designed the study, supervised all elements of data collection, analysis, and interpretation, assisted in statistical analysis, contributed to initial drafts of the manuscript, and reviewed and revised the final manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Matthew J. Kielt.

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Beer, L., Rivera, B.K., Jama, W. et al. Association of the respiratory severity score with bronchopulmonary dysplasia-associated pulmonary hypertension in infants born extremely preterm. J Perinatol 44, 294–300 (2024). https://doi.org/10.1038/s41372-023-01798-y

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