BMJ paediatrics open · 2026
Prevalence and severity of persistent pulmonary hypertension of the newborns among asphyxiated neonates admitted in Enugu State University Teaching Hospital.
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Okechukwu Ani, Odetunde Odutola, Uchenna Ekwochi, Chinawa Josephat M
Аннотация
BACKGROUND: Persistent pulmonary hypertension of newborns (PPHN) is an acute neonatal disorder with a high mortality rate despite several advances in its management.
DESIGN: This was a prospective cross-sectional study.
SETTING: 84 asphyxiated neonates were included. All the participants underwent complete transthoracic echocardiography to assess the parameters for the diagnosis of PPHN.
PATIENT: Newborns with PPHN diagnosed via echocardiography with perinatal asphyxia who were admitted to the newborn unit.
INTERVENTIONS: Echocardiography was performed within 72 hours of life. The mean age at echocardiography was 38.4±0.71 hours.
MAIN OUTCOME MEASURES: The severity of asphyxia, gestational age and place of birth (inborn), delivery at the study centre or 'out-born' and delivery at another facility or location away from the study centre were significantly associated with the development of PPHN.
RESULTS: The prevalence of PPHN in the study was 52.4%. The severity of asphyxia, gestational age and place of birth (inborn), delivery at the study centre or 'out-born' and delivery at another facility or location away from the study centre were significantly associated with the development of PPHN (p<0.05). Severe asphyxia was approximately nine times more likely to be associated with the development of PPHN than mild asphyxia (AOR=9.89; 95% CI 1.92 to 50.94, p=0.006) and was the single most significant predictor of PPHN in the present study. However, the severity of asphyxia was not associated with the severity of PPHN.
CONCLUSION AND RELEVANCE: Severe asphyxia was the single most significant predictor of the development of PPHN among asphyxiated neonates. The prevalence of PPHN among asphyxiated neonates was high. A high index of suspicion and the routine use of echocardiography and sildenafil to diagnose and treat PPHN in asphyxiated neonates are recommended.
DESIGN: This was a prospective cross-sectional study.
SETTING: 84 asphyxiated neonates were included. All the participants underwent complete transthoracic echocardiography to assess the parameters for the diagnosis of PPHN.
PATIENT: Newborns with PPHN diagnosed via echocardiography with perinatal asphyxia who were admitted to the newborn unit.
INTERVENTIONS: Echocardiography was performed within 72 hours of life. The mean age at echocardiography was 38.4±0.71 hours.
MAIN OUTCOME MEASURES: The severity of asphyxia, gestational age and place of birth (inborn), delivery at the study centre or 'out-born' and delivery at another facility or location away from the study centre were significantly associated with the development of PPHN.
RESULTS: The prevalence of PPHN in the study was 52.4%. The severity of asphyxia, gestational age and place of birth (inborn), delivery at the study centre or 'out-born' and delivery at another facility or location away from the study centre were significantly associated with the development of PPHN (p<0.05). Severe asphyxia was approximately nine times more likely to be associated with the development of PPHN than mild asphyxia (AOR=9.89; 95% CI 1.92 to 50.94, p=0.006) and was the single most significant predictor of PPHN in the present study. However, the severity of asphyxia was not associated with the severity of PPHN.
CONCLUSION AND RELEVANCE: Severe asphyxia was the single most significant predictor of the development of PPHN among asphyxiated neonates. The prevalence of PPHN among asphyxiated neonates was high. A high index of suspicion and the routine use of echocardiography and sildenafil to diagnose and treat PPHN in asphyxiated neonates are recommended.