Abstract 11333: High Prevalence of Pulmonary Hypertension Complicates Care of Infants With Omphalocele
Background: Many newborn infants born with an omphalocele present with significant respiratory distress at birth requiring mechanical ventilatory support and have clinical evidence of pulmonary hypertension (PH). Little information exists on the prevalence of PH in this cohort of infants. Therefore, our objective was to describe the prevalence of PH among infants with an omphalocele and identify risk factors associated with the presence of PH.
Methods: Demographic data and clinical characteristics were collected by retrospective chart review of infants with omphalocele admitted to LLUCH NICU or Children’s Mercy Hospital between 1994-2011. Infants were excluded from analysis if they had CHD. Echocardiograms were reviewed by a single pediatric cardiologist from each institution for PH based on presence of flattening of the interventricular septum and/or tricuspid regurgitant jet with estimated RV pressure > 40 mmHg. Data were summarized and compared between PH versus the no PH cohorts using Fisher’s exact test, two-sample t-test, or Mann-Whitney test as appropriate. Significance was set at p < 0.05.
Results: A total of 123 infants had omphalocele diagnosis. PH was diagnosed in 59/98 (60%) infants with an omphalocele. Slightly more infants with PH were male 30/59 (51%) with mean gestational age 36 +/- 3 weeks. There was no significant difference between the two groups in birthweight, chromosomal abnormalities, need for ventilator at birth, or number of days on a ventilator. Presence of liver in the omphalocele sac was more prevalent in the PH cohort compared to the no PH, 32/59 (54%) vs 11/39 (28%), respectively, p= 0.01.
Conclusion: This multicenter retrospective study demonstrates that the majority of infants with omphalocele have PH. These findings of PH may be more common than previously recognized. Therefore, we recommend screening for PH in all infants with omphalocele, especially those with liver within the omphalocele sac, within the first week of life.
- © 2013 by American Heart Association, Inc.