Anucha Thatrimontrichai, Pattima Pakhathirathien, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate, Ploypailin Jantarawongpisal, Jenjira Saechan
Prince of Songkla University.
Thailand
Journal of Clinical Medicine
J Clin Med 2025; 14:
DOI: 10.3390/jcm14134759
Abstract
Background/Objectives: To identify the risk factors and clinical outcomes of persistent pulmonary hypertension of the newborn (PPHN) in very low birth weight (VLBW) infants in a resource-limited setting.
Methods: We conducted a 1:4 matched case-control study in a Thai neonatal unit between 2014 and 2023. Neonates born at a gestational age (GA) < 32 weeks and with a birth weight (BW) < 1500 g were included. Neonates who died in the delivery room or had major congenital anomalies were excluded. Matching was based on GA, BW, year of birth, and endotracheal intubation at birth. Conditional logistic regression analysis was performed.
Results: Over the 10-year study period, the incidence of PPHN among VLBW neonates was 4.6% (31/667). After matching, there were 31 cases and 124 controls. In univariable analysis, PPHN was significantly associated with lower 1 min and 5 min Apgar scores; however, no significant association remained in multivariable analysis. PPHN was significantly associated with composite adverse outcomes-including mortality and major morbidities (adjusted odds ratio [aOR] = 7.51, 95% confidence interval [CI]: 2.41-23.40), mortality alone (aOR = 2.88, 95% CI: 1.06-7.63), major morbidities (aOR = 2.99; 95% CI: 1.29-6.95), and severe neurological injury (aOR = 4.44, 95% CI: 1.56-12.59). Daily hospital costs were also higher in PPHN cases, with an average increase of 97.1 USD.
Conclusions: In VLBW infants, PPHN was associated with a lower Apgar score and surfactant administration. PPHN was significantly linked to adverse outcomes, particularly mortality, major morbidities, and severe neurological injury.
Category
Class I. Persistent Pulmonary Hypertension of the Newborn
Potential Biomarkers Associated with Pulmonary Vascular Disease
Acquired Patient Factors Associated with Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes