Characteristics of Newborn with Persistent Pulmonary Hypertension (PPHN) Admitted In Neonatal Intensive Care Unit in a Tertiary Care Hospital

Abstract

Objectives: To find the frequency, aetiologies, treatment options and outcomes in neonates with persistent pulmonary hypertension of the new-born and to identify risk factors associated with severe pulmonary hypertension. Study Design: Prospective longitudinal study. Place and Duration of Study: Neonatal Intensive Care Unit, Fatima Memorial Hospital, Lahore Pakistan, from Apr to Oct 2020. Methodology: All neonates admitted to the Neonatal Unit with signs and symptoms suggestive of PPHN and confirmed on echocardiography were included in the study. Multiple maternal and neonatal risk factors leading to PPHN were identified. Results: A total of 70 neonates with persistent pulmonary hypertension were identified. The all-cause mortality rate was 18.6% (13 of 70). Pneumonia was the primary cause of pulmonary hypertension (64.3%). Pneumonia was the primary cause of pulmonary hypertension (64.3%). Out of 72, 46(65.7%) were male and 24(34.3%) were female. The mean gestational age was 35.38±3.39 weeks. On binary logistic regression analysis, severe pulmonary hypertension showed a significant association with maternal septic risk factors (OR 0.26, p=0.03, emergency section (OR 3.69, p=0.05). Conclusions: The persistent pulmonary hypertension of newborns in the current study was higher than in Western countries. Pneumonia and sepsis are the primary aetiologies of developing PPHN. Maternal septic risk factors and emergency section are associated with an increased risk of severe pulmonary hypertension.

Keywords

• Hypoxic ischemic encephalopathy (HIE)
• Neonatal intensive care unit
• Pneumonia
• Persistent pulmonary hypertension of the newborn (PPHN)