Risk factors and mortality among newborns with persistent pulmonary hypertension

Abstract

Objective: To determine the risk factors for persistent pulmonary hypertension of newborns (PPHN) and their influence on mortality.

Methods: This  was an observational study conducted at The Children’s Hospital & the Institute of Child Health, Multan, Pakistan, from July 2011 to June 2012.All admitted babies who had respiratory distress, cyanosis and evidence of  hypoxia on ABG,s were diagnosed provided that they were having right- to- left  or bidirectional hemodynamic shunting  at the ductus arteriosus or at patent foramen ovale along with Tricuspid regurgitation (TR) jet > 40 mm of Hg on echocardiography. All the demographic, maternal, antenatal, natal and postnatal data were recorded on a predesigned Performa.

Results: There were 79 patients, including 61 males and 18 females. The most common risk factors observed in our study were male sex (72.1%), cesarean section mode of delivery (54.2%), positive pressure ventilation while resuscitation (44.2%) birth asphyxia (40.4%) and meconium aspiration syndrome  (MAS)35.4%. It was found that male sex (88.8%), cesarean-section delivery (77.7%), respiratory distress syndrome (RDS) 44.8% and sepsis (44.4%) were more associated with PPHN in premature infants than with term and post term infants. Out of the total 79 patients, death occurred among 7 preterm and 14 terms and post term infants. As a whole, cesarean section mode of delivery (71.4%), birth asphyxia (57.1%) and female sex (52.4%) were found major risk factors associated with mortality. However, respiratory distress syndrome (Relative Risk RR=5), birth asphyxia (RR=2.5) and male sex (RR=2)were found to be associated with increased risk of mortality in preterm than term and post term infants.

Conclusion: Male gender, cesarean section mode of delivery, MAS and RDS are the major risk factors for PPHN in any age group. RDS, Birth asphyxia and male sex are associated with increased risk of mortality in pre term than term and post term infants.

doi: http://dx.doi.org/10.12669/pjms.295.3728

How to cite this:Razzaq A, Quddusi AI, Nizami N. Risk factors and mortality among newborns with persistent pulmonary hypertension. Pak J Med Sci 2013;29(5):1099-1104.   doi: http://dx.doi.org/10.12669/pjms.295.3728

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.