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Association between pulmonary vein stenosis and necrotizing enterocolitis or gastrointestinal pathology: A case–control study


1 Division of Neonatology, BronxCare Hospital System, Grand Concourse, Bronx, New York, USA
2 Department of Pediatrics, Columbia University Irving Medical Center, Broadway; Division of Neonatology, Valley Health System, New Jersey, New York, USA
3 Department of Pediatrics, Columbia University Irving Medical Center, Broadway; Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University Medical Center, New York, USA
4 Department of Pediatrics, Columbia University Irving Medical Center, Broadway, New York, USA

Correspondence Address:
Dr. Usha S Krishnan
Pulmonary Hypertension Center CHN 2N #255, Columbia University Irving Medical Center; New York, NY 10032
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_210_21

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Year : 2022  |  Volume : 15  |  Issue : 1  |  Page : 13-19

 

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Objective : Pulmonary vein stenosis (PVS) is an emerging cause of pulmonary hypertension in preterm infants. It is an often lethal condition with poor long.term prognosis and high mortality. Previous work suggests an association between necrotizing enterocolitis (NEC) and PVS, supporting a possible role for inflammatory processes due to gastrointestinal (GI) pathology as an associated risk factor for PVS. Study Description : We performed a matched case–control study where infants with PVS were matched for gestational age with infants without PVS. Hospital records were reviewed for prior history of NEC or other gut pathology. Results : Twenty-four PVS patients were matched with 68 controls; 63% of patients (15/24) had prior GI pathology as opposed to 19% (13/68) of controls. The GI pathology group had a significantly higher growth restriction and C-reactive protein. The mean gradient across the pulmonary veins was higher in the gut pathology group versus controls, as was mortality (29% vs. 9%). Conclusions : The previously described association between PVS and intestinal pathology was further strengthened by this study. The presence of GI pathology should lead to early surveillance and intervention for PVS.






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1 Division of Neonatology, BronxCare Hospital System, Grand Concourse, Bronx, New York, USA
2 Department of Pediatrics, Columbia University Irving Medical Center, Broadway; Division of Neonatology, Valley Health System, New Jersey, New York, USA
3 Department of Pediatrics, Columbia University Irving Medical Center, Broadway; Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University Medical Center, New York, USA
4 Department of Pediatrics, Columbia University Irving Medical Center, Broadway, New York, USA

Correspondence Address:
Dr. Usha S Krishnan
Pulmonary Hypertension Center CHN 2N #255, Columbia University Irving Medical Center; New York, NY 10032
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/apc.apc_210_21

Rights and Permissions

Objective : Pulmonary vein stenosis (PVS) is an emerging cause of pulmonary hypertension in preterm infants. It is an often lethal condition with poor long.term prognosis and high mortality. Previous work suggests an association between necrotizing enterocolitis (NEC) and PVS, supporting a possible role for inflammatory processes due to gastrointestinal (GI) pathology as an associated risk factor for PVS. Study Description : We performed a matched case–control study where infants with PVS were matched for gestational age with infants without PVS. Hospital records were reviewed for prior history of NEC or other gut pathology. Results : Twenty-four PVS patients were matched with 68 controls; 63% of patients (15/24) had prior GI pathology as opposed to 19% (13/68) of controls. The GI pathology group had a significantly higher growth restriction and C-reactive protein. The mean gradient across the pulmonary veins was higher in the gut pathology group versus controls, as was mortality (29% vs. 9%). Conclusions : The previously described association between PVS and intestinal pathology was further strengthened by this study. The presence of GI pathology should lead to early surveillance and intervention for PVS.






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