{"title":"南非林波波省mankeng医院新生儿病房新生儿持续性肺动脉高压的患病率和结局","authors":"M. Nchabeleng, Kenny Hamese, S. Ntuli","doi":"10.7196/SAJCH.2021.V15I2.01773","DOIUrl":null,"url":null,"abstract":"Background. Persistent pulmonary hypertension of the newborn (PPHN) is a condition of high pulmonary arterial pressures leading to hypoxaemia and continued shunting of blood across fetal channels as a result of failure of circulatory transition at birth. Objective. To determine the prevalence and outcomes of PPHN at Mankweng Hospital, Limpopo Province, South Africa. Methods. A retrospective descriptive review of patients’ files from January 2015 to December 2017 was conducted. PPHN was diagnosed on echocardiogram. Results. During the 3-year period of the study, a total of 6 776 neonates were admitted to the neonatal unit, of whom 0.76% ( n =52) were diagnosed with PPHN. Of these, 98% (n=51) had complete information in their medical records and were further analysed. Slightly more than half (53%) were males, 59% were delivered by caesarean section, 94% had gestational age ≥37 weeks, and 39% and 14% had Apgar scores of <6 at 1 minute and 5 minutes, respectively. Most neonates (72%) had meconium aspiration as the single risk factor or in combination with other conditions. Nearly half (45.1%) of the neonates with PPHN did not survive. Gender, mode of delivery, and Apgar score were each correlated with PPHN mortality and they all showed no statistically significant association. A significantly higher proportion of non-survivors received inotropic support than survivors ( p <0.05). Conclusions. The prevalence of PPHN was found to be lower than in other low- and middle-income countries; nonetheless, the all-cause mortality rate is significantly high. The commonest aetiology of PPHN is meconium aspiration syndrome as a single underlying risk factor, and in combination with other conditions. Most neonates who needed inotropic support died.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence and outcomes of persistent pulmonary hypertension of the newborn in a neonatal unit, Mankweng Hospital, Limpopo Province, South Africa\",\"authors\":\"M. Nchabeleng, Kenny Hamese, S. Ntuli\",\"doi\":\"10.7196/SAJCH.2021.V15I2.01773\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background. Persistent pulmonary hypertension of the newborn (PPHN) is a condition of high pulmonary arterial pressures leading to hypoxaemia and continued shunting of blood across fetal channels as a result of failure of circulatory transition at birth. Objective. To determine the prevalence and outcomes of PPHN at Mankweng Hospital, Limpopo Province, South Africa. Methods. A retrospective descriptive review of patients’ files from January 2015 to December 2017 was conducted. PPHN was diagnosed on echocardiogram. Results. During the 3-year period of the study, a total of 6 776 neonates were admitted to the neonatal unit, of whom 0.76% ( n =52) were diagnosed with PPHN. Of these, 98% (n=51) had complete information in their medical records and were further analysed. Slightly more than half (53%) were males, 59% were delivered by caesarean section, 94% had gestational age ≥37 weeks, and 39% and 14% had Apgar scores of <6 at 1 minute and 5 minutes, respectively. Most neonates (72%) had meconium aspiration as the single risk factor or in combination with other conditions. Nearly half (45.1%) of the neonates with PPHN did not survive. Gender, mode of delivery, and Apgar score were each correlated with PPHN mortality and they all showed no statistically significant association. A significantly higher proportion of non-survivors received inotropic support than survivors ( p <0.05). Conclusions. The prevalence of PPHN was found to be lower than in other low- and middle-income countries; nonetheless, the all-cause mortality rate is significantly high. The commonest aetiology of PPHN is meconium aspiration syndrome as a single underlying risk factor, and in combination with other conditions. Most neonates who needed inotropic support died.\",\"PeriodicalId\":44732,\"journal\":{\"name\":\"South African Journal of Child Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2021-07-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"South African Journal of Child Health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.7196/SAJCH.2021.V15I2.01773\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"South African Journal of Child Health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7196/SAJCH.2021.V15I2.01773","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
Prevalence and outcomes of persistent pulmonary hypertension of the newborn in a neonatal unit, Mankweng Hospital, Limpopo Province, South Africa
Background. Persistent pulmonary hypertension of the newborn (PPHN) is a condition of high pulmonary arterial pressures leading to hypoxaemia and continued shunting of blood across fetal channels as a result of failure of circulatory transition at birth. Objective. To determine the prevalence and outcomes of PPHN at Mankweng Hospital, Limpopo Province, South Africa. Methods. A retrospective descriptive review of patients’ files from January 2015 to December 2017 was conducted. PPHN was diagnosed on echocardiogram. Results. During the 3-year period of the study, a total of 6 776 neonates were admitted to the neonatal unit, of whom 0.76% ( n =52) were diagnosed with PPHN. Of these, 98% (n=51) had complete information in their medical records and were further analysed. Slightly more than half (53%) were males, 59% were delivered by caesarean section, 94% had gestational age ≥37 weeks, and 39% and 14% had Apgar scores of <6 at 1 minute and 5 minutes, respectively. Most neonates (72%) had meconium aspiration as the single risk factor or in combination with other conditions. Nearly half (45.1%) of the neonates with PPHN did not survive. Gender, mode of delivery, and Apgar score were each correlated with PPHN mortality and they all showed no statistically significant association. A significantly higher proportion of non-survivors received inotropic support than survivors ( p <0.05). Conclusions. The prevalence of PPHN was found to be lower than in other low- and middle-income countries; nonetheless, the all-cause mortality rate is significantly high. The commonest aetiology of PPHN is meconium aspiration syndrome as a single underlying risk factor, and in combination with other conditions. Most neonates who needed inotropic support died.