Journal article
Morbidity of Persistent Pulmonary Hypertension of the Newborn in the First Year of Life
The Journal of pediatrics, Vol.213, pp.58-65.e4
10/2019
DOI: 10.1016/j.jpeds.2019.06.053
PMID: 31399244
Abstract
To assess postdischarge mortality and morbidity in infants diagnosed with different etiologies and severities of persistent pulmonary hypertension of the newborn (PPHN), and to identify risk factors for these adverse clinical outcomes.
This was a population-based study using an administrative dataset linking birth and death certificates, hospital discharge and readmissions records from 2005 to 2012 in California. Cases were infants ≥34 weeks' gestational age with International Classification of Diseases,9th edition, codes consistent with PPHN. The primary outcome was defined as postdischarge mortality or hospital readmission during the first year of life. Crude and adjusted risk ratio (aRR) with 95% CIs were calculated to quantify the risk for the primary outcome and to identify risk factors.
Infants with PPHN (n = 7847) had an aRR of 3.5 (95% CI, 3.3-3.7) for the primary outcome compared with infants without PPHN (n = 3 974 536), and infants with only mild PPHN (n = 2477) had an aRR of 2.2 (95% CI, 2.0-2.5). Infants with congenital diaphragmatic hernia as the etiology for PPHN had an aRR of 8.2 (95% CI, 6.7-10.2) and infants with meconium aspiration syndrome had an aRR of 4.2 (95% CI, 3.7-4.6) compared with infants without PPHN. Hispanic ethnicity, small for gestational age, severe PPHN, and etiology of PPHN were risk factors for the primary outcome.
The postdischarge morbidity burden of infants with PPHN is large. These findings extend to infants with mild PPHN and etiologies with pulmonary vascular changes that are thought to be short term and recoverable. These data could inform counseling of parents.
Details
- Title: Subtitle
- Morbidity of Persistent Pulmonary Hypertension of the Newborn in the First Year of Life
- Creators
- Martina A Steurer - Department of Pediatrics, University of California San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA; California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA. Electronic address: martina.steurermuller@ucsf.eduRebecca J Baer - California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Diego, La Jolla, CAScott Oltman - Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA; California Preterm Birth Initiative, University of California San Francisco, San Francisco, CAKelli K Ryckman - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IASky K Feuer - California Preterm Birth Initiative, University of California San Francisco, San Francisco, CAElizabeth Rogers - Department of Pediatrics, University of California San Francisco, San Francisco, CA; California Preterm Birth Initiative, University of California San Francisco, San Francisco, CARoberta L Keller - Department of Pediatrics, University of California San Francisco, San Francisco, CALaura L Jelliffe-Pawlowski - Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA; California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.213, pp.58-65.e4
- DOI
- 10.1016/j.jpeds.2019.06.053
- PMID
- 31399244
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Grant note
- name: California Preterm Birth Initiative
- Language
- English
- Date published
- 10/2019
- Academic Unit
- Stead Family Department of Pediatrics; Epidemiology
- Record Identifier
- 9984214843102771
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