Factors Associated with Newborn Fatality Due to Persistent Pulmonary Hypertension

Objectives: This study is designed to explore factors associated with death in newborns with persistent pulmonary hypertension (PPHN). Methods: The clinical data of PPHN cases in the past ten years from a neonatal center in China were retrospectively collected and analyzed, and the death-related factors attributable to PPHN were analyzed by binary stepwise logistic regression analysis. Results: A total of 161 neonates with PPHN were included in this study, with a mortality rate of 18.0% (29/161). Multivariate binary logistic regression analysis indicated that cesarean delivery was negatively associated with death in infants with PPHN (adjusted odds ratio [OR] = 0.289, 95% confidence interval [CI] 0.104 – 0.803), while premature rupture of membranes (PROM) (adjusted OR = 4.032, 95% CI 1.32 - 12.32), congenital lung developmental abnormalities/congenital diaphragmatic hernia (CDH) (adjusted OR = 12.65, 95% CI 1.088 – 147.068), respiratory distress syndrome (RDS) (adjusted OR = 4.802, 95% CI 1.512 – 15.251), inhaled nitric oxide (iNO) (adjusted OR = 12.377, 95% CI 3.22 – 47.576) and norepinephrine (adjusted OR = 2.891, 95% CI 1.03 – 8.118) were the independent factors associated with a higher risk of death from PPHN. Conclusions: Caesarean delivery with medical indication is an independent protective factor against death in neonates with PPHN. PROM, congenital lung developmental abnormalities/CDH, RDS, iNO, and norepinephrine were independent death-related factors in neonates with PPHN.