Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation

Nargis Ara Begum; Sharmin Afroze; Runa Laila; Shahnaz Parvin Siddiqua; Mohammad Toyobur Rahaman

doi:doi:10.11648/j.ajp.20190503.20

| Peer-Reviewed

Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation

Nargis Ara Begum, Sharmin Afroze, Runa Laila, Shahnaz Parvin Siddiqua, Mohammad Toyobur Rahaman

Published in American Journal of Pediatrics (Volume 5, Issue 3)

Received: 14 June 2019 Accepted: 15 July 2019 Published: 12 August 2019

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Persistent Pulmonary Hypertension of Newborn (PPHN) is a critical neonatal problem resulting from failed circulatory adaptation at birth, associated with substantial perinatal morbidity as well as mortality. Despite significant advancement in management of PPHN across the globe, it still remains a challenge especially in developing countries like Bangladesh. So the study was conducted over five years in United Hospital Limited to determine the risk factors of PPHN in relation to gestational age. All PPHN cases diagnosed by echocardiogram were included in the study and divided into term (≥ 37 wks) and preterm group (<37 wks). Among 157 of PPHN cases, 66% were male, 59% were preterm, mean gestational age and birth weight were 35.6 ± 2.54 wks and 2598.22 ± 760.353 gm respectively. Maternal asthma (p 0.01) and pre-eclamptic toxemia (p 0.010) were significant risk factors for persistent pulmonary hypertension of newborn. PPHN was found high in neonates with Respiratory Distress Syndrome (p 0.000) and Meconium Aspiration Syndrome (p 0.000). Most (96%) of the babies were discharged to home.

Published in	American Journal of Pediatrics (Volume 5, Issue 3)
DOI	10.11648/j.ajp.20190503.20
Page(s)	142-147
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Persistent Pulmonary Hypertension, Risk Factors, Persistent Fetal Circulation

References

[1]	Gomella TL, Cunningham DM, EyalFG, editors. Neonatology: Management, Procedures, On–call Problems, Diseasesand Drugs. Seventh edition. NewYork. Mc Graw Hill, Lange. 2013; P. 400-9.
[2]	Razzaq A, Quddusi AI, Nizami N. Risk factors and mortality among newborns with persistent pulmonary hypertension. Pak J Med Sci. 2013; 29 (5).
[3]	Abman SH. Recent advances in the pathogenesis and treatment of persistent pulmonary hypertension of the newborn. Neonatology. 2007; 91: 283–90.
[4]	ShahPS, Ohlsson A. Sildenafil for pulmonary hypertension in neonates. Cochrane Database Syst Rev. 2007; (3).
[5]	Mac Lean MR. Endothelin 1 and serotonin: mediators of primary and secondary pulmonary hypertension. J Lab Clin Me. 1999; 134: 105-114.
[6]	Dakshinamurti S. Pathophysiologic mechanisms of persistent pulmonary hypertension of the newborn. Pediatr Pulmonol Suppl. 2005; 39 (6): 492–503.
[7]	Hernández DS, V an Marter LJ, Werler MM, Louik C, Mitchell AA. Risk factors for persistent pulmonary hypertension of the newborn. Pediatrics. 2007; 120 (2): e272–82.
[8]	Winovitch KC, PadillaL, Ghamsary M, Lagrew DC, Wing DA. Persistent pulmonary hypertension of the newborn following elective cesarean delivery at term. J Matern Fetal Neonatal Med. 2011; 24 (11): 1398–402.
[9]	Puthiyachirakkal M, M hanna MJ. Pathophysiology, management, and outcome of persistent pulmonary hypertension of the newborn: a clinical review. Frontiers in Pediatrics. Child Health and Human Development (2013); 1.
[10]	Walsh Sukys M, Tyson J, Wright L. Persistent pulmonary hypertension of the Newborn in the era before nitric oxide: practice variation and outcomes. Pediatrics. 2000; 105: 14–20.
[11]	Fricker J. Nitric oxide may reduce need for extra corporeal membrane oxygenation. Lancet. 1996; 347: 1397.
[12]	Clark R, Keuser T, Walker Metal. Low-dose nitric oxide therapy for Persistent pulmonary hypertension of the newborn. N Engl J Med. 2000; 342: 469–474.
[13]	Clark R, Huckaby J, Kueser Tetal. Low-dose nitric oxide therapy for persistent pulmonary hypertension:1-year follow up. J Perinatol. 2003; 23: 300–303.
[14]	Glass P, Wagner A, Papero Petal. Neurodevelopmental status at age five years of neonates treated with extracorporeal membrane oxygenation. JPediatr. 1995; 127: 447–457.
[15]	TengRJ, WuTJ. Persistent pulmonary hypertension of the newborn. J Formos Med Assoc. 2013; 112(4): 177–184.
[16]	Travadi JN, Patole SK. Phosphodiesterase inhibitors for persistent pulmonary Hypertension of the newborn: A review. Pediatr Pulmonol. 2003; 36: 529–535.
[17]	Martina A. S, LauraL, JelliffeP, Rebecca J. B, ColinP, Elizabeth E. Retal. Persistent Pulmonary Hypertension of the Newborn in Late Preterm and Term Infants in California. PEDIATRICS. 2017; 1(39).
[18]	Gersony W, Duc G, SinclairJ. “PFC” syndrome (persistence of the fetal circulation). Circulation. 1969; 39 (suppl III):87.
[19]	Goldberg S, Levy R, Siassi B, BetternJ. The effects of maternal hypoxia and Hyperoxia upon the neonatal pulmonary vasculature. Pediatrics. 1971; 48:528–533.
[20]	Ahmed T, Abqari S, Shahab T, Ali M, Firdaus U. Prevalence of pulmonary Arterial hypertension on echocardiography in newborns with maternal risk factors. International Journal of Pregnancy & Child Birth. 2017; 3 (1).
[21]	Shih T, Peneva D, Xu X, et al. The rising burden of preeclampsia in the United States impacts both maternal and child health. AmJ Perinatol. 2016; 33(4): 329–338.
[22]	Wilson KL, Selig CM, Harvey JP, Cunningham BS, Dolinsky BM, Napolitano PG. Persistent pulmonary hypertension of the newborn is associated with mode of delivery and not with maternal use of selective serotonin reuptake inhibitors. Am J Perinatol. 2011; 28(1): 19-24.
[23]	Hassan M, Begum M, Haque Z, Jahan N, Yasmeen N, Mannan A et al. Immediate outcome of neonates with maternal hypertensive disorder of Pregnancy at a neonatal intensive care unit. Northern International Medical College Journal. 2015; 6 (2): 57-60.
[24]	Dudell G. G, Jain L. Hypoxic respiratory failure in the late preterm infant. Clinicsin Perinatology. 2006; 33 (4): 830-830.
[25]	NairJ, Lakshminrusimha S. Update on PPHN: Mechanisms and treatment. Semin Perinatol.2014; 38 (2): 78–91.
[26]	Cassidy Delaney and David N. Cornfield. Risk factors for persistent Pulmonary hypertension of the newborn. Pulmonary Circulation. 2012; (2): 1.
[27]	Dobyns EL, Wescott JY, Kennaugh JM, Ross MN, Stenmark KR. Eicosanoids Decrease with successful extra-corporeal membrane oxygenation therapy in Neonatal pulmonary hypertension. American Journal of Respiratory & Critical Care Medicine. 1994; 149: 873–808.
[28]	Fatema NN. Persistent Pulmonary Hypertension of the Newborn: Analysis of 181 cases over one year. Cardiovasc. j. 2018; 11 (1): 17-22.
[29]	Agha H, Tantawy A, IskanderI, Samad A. Impact of Management Strategies On the Outcome of Persistent Pulmonary Hypertension of the Newborn. Fortune Journals; 2017.

Cite This Article

Plain Text BibTeX RIS

APA Style

Nargis Ara Begum, Sharmin Afroze, Runa Laila, Shahnaz Parvin Siddiqua, Mohammad Toyobur Rahaman. (2019). Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation. American Journal of Pediatrics, 5(3), 142-147. https://doi.org/10.11648/j.ajp.20190503.20

Copy | Download

ACS Style

Nargis Ara Begum; Sharmin Afroze; Runa Laila; Shahnaz Parvin Siddiqua; Mohammad Toyobur Rahaman. Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation. Am. J. Pediatr. 2019, 5(3), 142-147. doi: 10.11648/j.ajp.20190503.20

Copy | Download

AMA Style

Nargis Ara Begum, Sharmin Afroze, Runa Laila, Shahnaz Parvin Siddiqua, Mohammad Toyobur Rahaman. Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation. Am J Pediatr. 2019;5(3):142-147. doi: 10.11648/j.ajp.20190503.20

Copy | Download

@article{10.11648/j.ajp.20190503.20,
  author = {Nargis Ara Begum and Sharmin Afroze and Runa Laila and Shahnaz Parvin Siddiqua and Mohammad Toyobur Rahaman},
  title = {Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation},
  journal = {American Journal of Pediatrics},
  volume = {5},
  number = {3},
  pages = {142-147},
  doi = {10.11648/j.ajp.20190503.20},
  url = {https://doi.org/10.11648/j.ajp.20190503.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190503.20},
  abstract = {Persistent Pulmonary Hypertension of Newborn (PPHN) is a critical neonatal problem resulting from failed circulatory adaptation at birth, associated with substantial perinatal morbidity as well as mortality. Despite significant advancement in management of PPHN across the globe, it still remains a challenge especially in developing countries like Bangladesh. So the study was conducted over five years in United Hospital Limited to determine the risk factors of PPHN in relation to gestational age. All PPHN cases diagnosed by echocardiogram were included in the study and divided into term (≥ 37 wks) and preterm group (<37 wks). Among 157 of PPHN cases, 66% were male, 59% were preterm, mean gestational age and birth weight were 35.6 ± 2.54 wks and 2598.22 ± 760.353 gm respectively. Maternal asthma (p 0.01) and pre-eclamptic toxemia (p 0.010) were significant risk factors for persistent pulmonary hypertension of newborn. PPHN was found high in neonates with Respiratory Distress Syndrome (p 0.000) and Meconium Aspiration Syndrome (p 0.000). Most (96%) of the babies were discharged to home.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation
AU  - Nargis Ara Begum
AU  - Sharmin Afroze
AU  - Runa Laila
AU  - Shahnaz Parvin Siddiqua
AU  - Mohammad Toyobur Rahaman
Y1  - 2019/08/12
PY  - 2019
N1  - https://doi.org/10.11648/j.ajp.20190503.20
DO  - 10.11648/j.ajp.20190503.20
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 142
EP  - 147
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20190503.20
AB  - Persistent Pulmonary Hypertension of Newborn (PPHN) is a critical neonatal problem resulting from failed circulatory adaptation at birth, associated with substantial perinatal morbidity as well as mortality. Despite significant advancement in management of PPHN across the globe, it still remains a challenge especially in developing countries like Bangladesh. So the study was conducted over five years in United Hospital Limited to determine the risk factors of PPHN in relation to gestational age. All PPHN cases diagnosed by echocardiogram were included in the study and divided into term (≥ 37 wks) and preterm group (<37 wks). Among 157 of PPHN cases, 66% were male, 59% were preterm, mean gestational age and birth weight were 35.6 ± 2.54 wks and 2598.22 ± 760.353 gm respectively. Maternal asthma (p 0.01) and pre-eclamptic toxemia (p 0.010) were significant risk factors for persistent pulmonary hypertension of newborn. PPHN was found high in neonates with Respiratory Distress Syndrome (p 0.000) and Meconium Aspiration Syndrome (p 0.000). Most (96%) of the babies were discharged to home.
VL  - 5
IS  - 3
ER  -

Copy | Download

Author Information

Nargis Ara Begum

Department of Neonatology, United Hospital Limited, Dhaka, Bangladesh
Sharmin Afroze

Department of Neonatology, Dr. M R Khan Shishu (Children) Hospital & Institute of Child Health, Dhaka, Bangladesh
Runa Laila

Department of Neonatology, United Hospital Limited, Dhaka, Bangladesh
Shahnaz Parvin Siddiqua

Department of Neonatology, United Hospital Limited, Dhaka, Bangladesh
Mohammad Toyobur Rahaman

Department of Neonatology, United Hospital Limited, Dhaka, Bangladesh

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Nargis Ara Begum, Sharmin Afroze, Runa Laila, Shahnaz Parvin Siddiqua, Mohammad Toyobur Rahaman. (2019). Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation. American Journal of Pediatrics, 5(3), 142-147. https://doi.org/10.11648/j.ajp.20190503.20

Copy | Download

ACS Style

Nargis Ara Begum; Sharmin Afroze; Runa Laila; Shahnaz Parvin Siddiqua; Mohammad Toyobur Rahaman. Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation. Am. J. Pediatr. 2019, 5(3), 142-147. doi: 10.11648/j.ajp.20190503.20

Copy | Download

AMA Style

Nargis Ara Begum, Sharmin Afroze, Runa Laila, Shahnaz Parvin Siddiqua, Mohammad Toyobur Rahaman. Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation. Am J Pediatr. 2019;5(3):142-147. doi: 10.11648/j.ajp.20190503.20

Copy | Download

@article{10.11648/j.ajp.20190503.20,
  author = {Nargis Ara Begum and Sharmin Afroze and Runa Laila and Shahnaz Parvin Siddiqua and Mohammad Toyobur Rahaman},
  title = {Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation},
  journal = {American Journal of Pediatrics},
  volume = {5},
  number = {3},
  pages = {142-147},
  doi = {10.11648/j.ajp.20190503.20},
  url = {https://doi.org/10.11648/j.ajp.20190503.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190503.20},
  abstract = {Persistent Pulmonary Hypertension of Newborn (PPHN) is a critical neonatal problem resulting from failed circulatory adaptation at birth, associated with substantial perinatal morbidity as well as mortality. Despite significant advancement in management of PPHN across the globe, it still remains a challenge especially in developing countries like Bangladesh. So the study was conducted over five years in United Hospital Limited to determine the risk factors of PPHN in relation to gestational age. All PPHN cases diagnosed by echocardiogram were included in the study and divided into term (≥ 37 wks) and preterm group (<37 wks). Among 157 of PPHN cases, 66% were male, 59% were preterm, mean gestational age and birth weight were 35.6 ± 2.54 wks and 2598.22 ± 760.353 gm respectively. Maternal asthma (p 0.01) and pre-eclamptic toxemia (p 0.010) were significant risk factors for persistent pulmonary hypertension of newborn. PPHN was found high in neonates with Respiratory Distress Syndrome (p 0.000) and Meconium Aspiration Syndrome (p 0.000). Most (96%) of the babies were discharged to home.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Risk Factors of Persistent Pulmonary Hypertension of Newborn (PPHN) in Different Gestation
AU  - Nargis Ara Begum
AU  - Sharmin Afroze
AU  - Runa Laila
AU  - Shahnaz Parvin Siddiqua
AU  - Mohammad Toyobur Rahaman
Y1  - 2019/08/12
PY  - 2019
N1  - https://doi.org/10.11648/j.ajp.20190503.20
DO  - 10.11648/j.ajp.20190503.20
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 142
EP  - 147
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20190503.20
AB  - Persistent Pulmonary Hypertension of Newborn (PPHN) is a critical neonatal problem resulting from failed circulatory adaptation at birth, associated with substantial perinatal morbidity as well as mortality. Despite significant advancement in management of PPHN across the globe, it still remains a challenge especially in developing countries like Bangladesh. So the study was conducted over five years in United Hospital Limited to determine the risk factors of PPHN in relation to gestational age. All PPHN cases diagnosed by echocardiogram were included in the study and divided into term (≥ 37 wks) and preterm group (<37 wks). Among 157 of PPHN cases, 66% were male, 59% were preterm, mean gestational age and birth weight were 35.6 ± 2.54 wks and 2598.22 ± 760.353 gm respectively. Maternal asthma (p 0.01) and pre-eclamptic toxemia (p 0.010) were significant risk factors for persistent pulmonary hypertension of newborn. PPHN was found high in neonates with Respiratory Distress Syndrome (p 0.000) and Meconium Aspiration Syndrome (p 0.000). Most (96%) of the babies were discharged to home.
VL  - 5
IS  - 3
ER  -

Copy | Download