Pulmonary hypertension in neonates: does the cause influence the outcome?

To determine the influence of the cause of pulmonary hypertension in neonates on overall outcome.

Analytical study.

Special Care Baby Unit (SCBU) at Royal Hospital in Muscat, Sultanate of Oman, from July 1998 to June 2003.

All neonates with the diagnosis of pulmonary hypertension, based on history, clinical examination and 2-D echocardiogram were reviewed with respect to the cause of hypertension (primary or secondary), birth weight, Apgar score, gender, inborn/outborn and outcome. According to the outcome, neonates were divided into two groups, group A (survived) and group B (expired). Both groups were compared for described variables using Statistical Package for Social Sciences, version 7.5 for Windows and Epi Info version 6.

Out of 37 neonates with pulmonary hypertension, Group A comprised of 22 neonates while group B had 15 neonates, giving a mortality of 40 % (15/37). The mean birth weight between the two groups showed no significant differences, 3088 +/- 479 gram and 2962 +/- 454 gram, p =0.42, respectively. Similarly, no difference in the one and five Apgar scores were noted, 4.9 +/- 2.1 and 4.7 +/- 1.3, p = 0.73 and 7.4 +/- 1.5 and 6.7 +/- 1.4, p = 0.16, respectively. The place of birth had also no significant influence on the outcome, however, the cause of pulmonary hypertension was noted to be significantly associated with the outcome, p =0.004.

The cause of pulmonary hypertension in neonates does influence the survival. Primary pulmonary hypertension in neonates was noted to be associated with poor outcome as compared to secondary pulmonary hypertension.