Incidence and outcomes of persistent pulmonary hypertension of the newborn at Prachuapkhirikhan Hospital

Abstract

Background: Persistent pulmonary hypertension of the newborn (PPHN) is a critical neonatal condition characterized by the failure of the circulatory system to transition appropriately after birth, leading to elevated pulmonary arterial pressure and impaired oxygenation. If not promptly diagnosed and treated, this condition may result in severe hypoxemia and can be life-threatening.

Objectives: To determine the incidence, clinical characteristics, treatment outcomes , and mortality rate of infants diagnosed with persistent pulmonary hypertension of the newborn  at Prachuapkhirikhan Hospital.

Methods: This is a retrospective descriptive study. Medical records of infants diagnosed with PPHN at Prachuapkhirikhan Hospital between October 1, 2020 and September 30, 2024 were reviewed.

Results: A total of 25 infants were diagnosed with PPHN during the study period. The incidence was 4.06 per 1,000 live births. Of the 25 cases with complete data, 19 were male (76%), and 76% were Thai.
The mean gestational age was 37.3 ± 3.2 weeks, and 48% were vaginal delivered. The most common cause of PPHN was congenital pneumonia (52%). The mortality rate was 40%. The non-survivor group had significantly higher maximum positive inspiratory pressure (22.2 ± 3.46; p value 0.029), maximum mean airway pressure (21.8 ± 3.32; p value 0.007), and maximum oxygen index (49.3 ± 13.1; p value 0.001) compared to the survivor group. Pneumothorax was diagnosed in 5 out of 6 non-survivors (83.3%), which was significantly higher than in the survivor group (p value 0.013).

Conclusions: The mortality rate of PPHN at Prachuapkhirikhan Hospital remained high compared to the national incidence in Thailand, which was reported at 1.88 to 3.7 per 1,000 live births. The leading cause was congenital pneumonia. Pneumothorax is a significant risk factor associated with mortality in PPHN.