Characteristics and outcomes of preterm infants with pulmonary vein stenosis in the contemporary era: a PHIS database analysis

BACKGROUND: Pulmonary vein stenosis (PVS) is increasingly recognized in preterm infants, yet data regarding characteristics and outcomes remain limited. METHODS: A review of hospitalizations from 50 children's hospitals across the United States participating in the Pediatric Health Information System (PHIS) database was performed. We identified 268,461 pediatric patients (≤24 months of age) with a history of prematurity (<37 weeks' gestation) admitted between 2016 and 2024. PVS was identified in 703 (0.3%) using ICD-10 diagnosis code I28.8. RESULTS: Bronchopulmonary dysplasia, birthweight ≤1.5 kg, Oxygen and ventilator dependency at discharge, pulmonary hypertension, left-to-right shunt lesions, and necrotizing enterocolitis were associated with PVS. Interestingly, gestational age <28 weeks was not associated with PVS. Patients with PVS had higher in-hospital mortality (11.4% vs 2%, p < 0.01), longer hospitalization, and substantially higher adjusted hospitalization costs. After adjusting for prematurity and comorbidities, PVS remained associated with in-hospital mortality (OR 4.3, 95% CI 3.4-5.5, p < 0.01). CONCLUSION: PVS in preterm infants is associated with in-hospital mortality, morbidity, and resource utilization, highlighting the need for improved recognition and structured surveillance.