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Neurodevelopmental outcome following persistent pulmonary hypertension of the neonate
A M Leavitt1, J F Watchko, F C Bennett
1Clinical Assistant Professor in Pediatrics, University of Washington, Seattle 98195.
Insights
Persistent pulmonary hypertension of the newborn (PPHN) survivors show concerning neurodevelopmental issues. Early hearing evaluations are recommended for these neonatal intensive care unit graduates.
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Persistent pulmonary hypertension of the newborn (PPHN) is a serious neonatal condition requiring intensive care.
- Infants with PPHN often undergo prolonged mechanical ventilation, posing potential risks for neurodevelopmental outcomes.
- Understanding the long-term neurodevelopmental impact of PPHN is crucial for optimizing patient care.
Purpose of the Study:
- To assess the neurodevelopmental status of infants diagnosed with PPHN.
- To identify the incidence of neurodevelopmental abnormalities, including hearing impairment, in this cohort.
- To advocate for early audiological screening in PPHN survivors.
Main Methods:
- A cohort of 12 infants with documented PPHN was evaluated.
- All participants required mechanical ventilation for at least 72 hours.
- Neurodevelopmental assessments were performed at a mean age of 20 months.
Main Results:
- Five out of 12 (42%) infants had normal neurodevelopmental outcomes.
- Three infants were considered suspect but not definitively abnormal.
- Four infants (33%) exhibited neurodevelopmental abnormalities, with three diagnosed with sensorineural hearing impairment (25% incidence).
Conclusions:
- A significant proportion of PPHN survivors experience neurodevelopmental dysfunction.
- Sensorineural hearing impairment is a notable concern in this population.
- Routine early hearing evaluations are essential for PPHN survivors to ensure timely intervention.
Abstract:
The neurodevelopmental status of 12 children with persistent pulmonary hypertension of the newborn (PPHN) was examined. All had neonatal documentation of PPHN by echocardiogram, and all were ventilated at least 72 hours. The mean age at follow-up was 20 months (range, 12-28). Five of the 12 subjects were normal at follow-up, three were felt to be suspect but not clearly abnormal, and four had neurodevelopmental abnormalities, including three with sensorineural hearing impairment (25 per cent incidence in this study). These findings represent a concerning frequency of neurodevelopmental dysfunction and support early routine hearing evaluation in this unique subgroup of neonatal intensive care unit survivors.