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Published on: March 6, 2019
Risk factors and mortality among newborns with persistent pulmonary hypertension
Athar Razzaq1, Ahmed Iqbal Quddusi2, Naila Nizami3
1Dr. Athar Razzaq,MBBS, FCPS, Trainee Fellow in Neonatal Pediatrics, The Children Hospital &Institute of Child Health, Multan, Pakistan.
Insights
Male gender, cesarean section, and birth asphyxia are key risk factors for persistent pulmonary hypertension of newborns (PPHN). These factors also increase mortality risk, particularly in preterm infants.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Perinatology
Background:
- Persistent Pulmonary Hypertension of Newborns (PPHN) is a critical neonatal condition.
- Identifying risk factors and mortality predictors is crucial for improving outcomes.
Purpose of the Study:
- To investigate the risk factors associated with PPHN.
- To analyze the impact of these risk factors on neonatal mortality.
Main Methods:
- An observational study was conducted with 79 neonates diagnosed with PPHN.
- Data collected included demographic, maternal, and perinatal factors.
- Echocardiography confirmed hemodynamic shunting and Tricuspid regurgitation.
Main Results:
- Male sex, cesarean delivery, and birth asphyxia were prominent risk factors for PPHN.
- Cesarean delivery, birth asphyxia, and female sex were linked to higher mortality.
- Respiratory Distress Syndrome (RDS), birth asphyxia, and male sex increased mortality risk in preterm infants.
Conclusions:
- Male gender, cesarean delivery, Meconium Aspiration Syndrome (MAS), and RDS are significant risk factors for PPHN.
- RDS, birth asphyxia, and male sex are associated with increased mortality in preterm neonates.
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.
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