Prediction of cardiovascular risk in infants with bronchopulmonary dysplasia

BACKGROUND: Respiratory, neurological and other outcomes of bronchopulmonary dysplasia in infants are well documented. However, the incidence and severity of cardiovascular abnormalities require further research.

AIM: The aim of the study was to establish cardiovascular risk criteria in infants with bronchopulmonary dysplasia and develop a mathematical model to predict cardiovascular abnormalities.

METHODS: A total of 1931 perinatal discharge records were analyzed. The final analysis included 274 source records. The main group was divided into two subgroups: 91 infants with cardiovascular abnormalities and 46 infants without cardiovascular abnormalities. The analysis included 225 parameters of perinatal history, laboratory and functional diagnostic tests. Discriminant and correlation analyses were performed using SPSS for statistical data processing.

RESULTS: Cardiovascular abnormalities were found in 66.4% of infants with bronchopulmonary dysplasia at 3 months of age and were represented by morphological changes such as functional patent foramen ovale, patent ductus arteriosus, and prolonged exposure to these conditions. Circulatory failure, transient pulmonary hypertension and combinations of cardiovascular abnormalities were reported.

Nine significant cardiovascular risk factors were identified, such as patent ductus arteriosus, gestational age ≤ 32 weeks, use of two doses of surfactant, time of prenatal care enrollment, duration of mechanical ventilation and oxygen dependence > 28 days, grade III–IV cerebral ischemia, severe retinopathy, body weight < 1 kg.

A formula was developed to predict a low, moderate, or high cardiovascular risk (98%).

CONCLUSION: In infants with bronchopulmonary dysplasia at 3 months of age, estimated individual cardiovascular risk helps differentiate the approach to preventing heart and blood vessel damage.