Prevalence of Persistent Pulmonary Hypertension of the Newborn and Associated Factors in Term Neonates Born in Southeast of Iran, 2020

 Background and purpose: Infants with persistent pulmonary hypertension (PPHN) are readmitted to hospital three times more than other infants or die after discharge. The disease imposes a high cost on families and health systems. In this study, for the first time, the prevalence of PPHN and associated factors were investigated in mature neonates born in southeast of Iran. Materials and methods: In this cross-sectional study, the clinical records of 1859 infants born in Kerman Afzalipour Hospital, 2020 were reviewed. Infants hospitalized from delivery, congenital heart disease, other differential diagnoses of PPHN, and evidence of genetic diseases were excluded from the study. Then, mature infants with clinical evidence of PPHN underwent Doppler echocardiography to confirm the final diagnosis. Information about pregnancy, childbirth, infant gender, birth, 1-minute and 5-minute Apgar scores, and advanced respiratory support were also obtained. Data were analyzed by SPSS V25. Results: Out of 229 neonates meeting the inclusion criteria, 31 (11.9%) had PPHN. Signification relationship was observed between frequency of PPHN and cesarean delivery and 5-minute minute Apgar score (P<0.05). But, no significant association was found between developing PPHN and other maternal or neonatal factors (P>0.05). The mean parameters of PPHN, including tricuspid annular plane systolic excursion (TAPSE), tricuspid regurgitation rate, mean pulmonary artery pressure, and pulmonary artery diameter were significantly higher in infants delivered by cesarean section than those born by normal vaginal delivery group (P<0.05). Conclusion: Further multicenter studies with larger sample size over a longer period of time are suggested in southeast of Iran to elicit clear explanations on the association between PPHN and maternal, fetal, and neonatal factors.