Survival and associated risk factors for mortality among infants with persistent pulmonary hypertension of the newborn in Malaysia
Objective This study aims to determine the immediate outcome of persistent pulmonary hypertension of the newborn (PPHN) and risk factors for mortality in the era of inhaled nitric oxide (iNO). Study design This observational cross-sectional study includes 195 confirmed PPHN with a gestational age of...
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| Veröffentlicht in: | Journal of perinatology 2021-04, Vol.41 (4), p.786-793 |
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| container_title | Journal of perinatology |
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| creator | Mat Bah, Mohd Nizam Tan, Racine Yuh Hwa Razak, Hasliza Sapian, Mohd Hanafi Abdullah, Nisah Alias, Emieliyuza Yusnita |
| description | Objective
This study aims to determine the immediate outcome of persistent pulmonary hypertension of the newborn (PPHN) and risk factors for mortality in the era of inhaled nitric oxide (iNO).
Study design
This observational cross-sectional study includes 195 confirmed PPHN with a gestational age of ≥34 weeks without congenital heart disease. Multivariable logistic regression was used to identify risk factors for mortality.
Results
The mortality rate was 16.4%, with the highest mortality with pulmonary hypoplasia. Of 195, 65% received iNO; 18% were iNO non-responders with the majority having pulmonary hypoplasia. Independent risk factors for mortality were the presence of reversal of flow at the descending aorta, pulmonary hypoplasia, APGAR scores ≤ 5 at 5 min, and idiopathic PPHN with an adjusted odds ratio of 15.9, 7.5, 6.7, and 6.4, respectively.
Conclusions
Despite the usage of iNO, mortality due to PPHN remains high and is related to etiology and cardiac function. |
| doi_str_mv | 10.1038/s41372-021-00962-6 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7883964</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A658607836</galeid><sourcerecordid>A658607836</sourcerecordid><originalsourceid>FETCH-LOGICAL-c572t-355f10030e3f6a24e61e73128423d5b61ec648caf0f060c53553e3863fdb22bd3</originalsourceid><addsrcrecordid>eNp9ks1rFDEYxgdR7Lb6D3iQgFB6mZrvyV6EUvyCigf1HDKZZCc1k6xJZste_cvNurXtisgcwrzv73mSvHma5gWC5wgS8TpTRDrcQoxaCJcct_xRs0C04y1jlDxuFrCjpBWE8qPmOOdrCHfN7mlzRAgTyw6LRfPzy5w2bqM8UGEAKueonSpmAMnl78AqXWLKwMYEppiK8q5sgZpiWAEXrAolgxtXRrA2KbtcTChgPfvaV2kLxm0t11p2MYBoQRkNCOamjylUNfikvNpmp541T6zy2Ty_XU-ab-_efr380F59fv_x8uKq1azDpSWMWQQhgYZYrjA1HJmOICwoJgPr65_mVGhloYUcalZ5YojgxA49xv1ATpo3e9_13E9m0PWwSXm5Tm6qp5VROXnYCW6Uq7iRnRBkyWk1OLs1SPHHbHKRk8vaeK-CiXOWmC4hwlRAVtFXf6HXcU6hXk9ihvCSQ8ToPbVS3sg60Fj31TtTecGZ4LAThFfq_B9U_QYzOR2Dsa7WDwSnDwSjUb6MOfq51HfIhyDegzrFnJOxd8NAUO4iJvcRkzVi8nfE5E708uEY7yR_MlUBsgdybYWVSfd3_4_tLxJX3Tk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2512960154</pqid></control><display><type>article</type><title>Survival and associated risk factors for mortality among infants with persistent pulmonary hypertension of the newborn in Malaysia</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Mat Bah, Mohd Nizam ; Tan, Racine Yuh Hwa ; Razak, Hasliza ; Sapian, Mohd Hanafi ; Abdullah, Nisah ; Alias, Emieliyuza Yusnita</creator><creatorcontrib>Mat Bah, Mohd Nizam ; Tan, Racine Yuh Hwa ; Razak, Hasliza ; Sapian, Mohd Hanafi ; Abdullah, Nisah ; Alias, Emieliyuza Yusnita</creatorcontrib><description>Objective
This study aims to determine the immediate outcome of persistent pulmonary hypertension of the newborn (PPHN) and risk factors for mortality in the era of inhaled nitric oxide (iNO).
Study design
This observational cross-sectional study includes 195 confirmed PPHN with a gestational age of ≥34 weeks without congenital heart disease. Multivariable logistic regression was used to identify risk factors for mortality.
Results
The mortality rate was 16.4%, with the highest mortality with pulmonary hypoplasia. Of 195, 65% received iNO; 18% were iNO non-responders with the majority having pulmonary hypoplasia. Independent risk factors for mortality were the presence of reversal of flow at the descending aorta, pulmonary hypoplasia, APGAR scores ≤ 5 at 5 min, and idiopathic PPHN with an adjusted odds ratio of 15.9, 7.5, 6.7, and 6.4, respectively.
Conclusions
Despite the usage of iNO, mortality due to PPHN remains high and is related to etiology and cardiac function.</description><identifier>ISSN: 0743-8346</identifier><identifier>EISSN: 1476-5543</identifier><identifier>DOI: 10.1038/s41372-021-00962-6</identifier><identifier>PMID: 33589728</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>692/308/409 ; 692/499 ; Administration, Inhalation ; Aorta ; Apgar score ; Cardiovascular diseases ; Care and treatment ; Coronary artery disease ; Etiology ; Gestational age ; Heart diseases ; Humans ; Hypertension ; Hypertension, Pulmonary - drug therapy ; Hypoplasia ; Infant ; Infant, Newborn ; Infants ; Malaysia - epidemiology ; Medicine ; Medicine & Public Health ; Mortality ; Newborn babies ; Nitric oxide ; Nitric Oxide - therapeutic use ; Patient outcomes ; Pediatric research ; Pediatric Surgery ; Pediatrics ; Persistent Fetal Circulation Syndrome - drug therapy ; Persistent Fetal Circulation Syndrome - epidemiology ; Pulmonary hypertension ; Risk analysis ; Risk Factors</subject><ispartof>Journal of perinatology, 2021-04, Vol.41 (4), p.786-793</ispartof><rights>The Author(s), under exclusive licence to Springer Nature America, Inc. part of Springer Nature 2021</rights><rights>COPYRIGHT 2021 Nature Publishing Group</rights><rights>The Author(s), under exclusive licence to Springer Nature America, Inc. part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c572t-355f10030e3f6a24e61e73128423d5b61ec648caf0f060c53553e3863fdb22bd3</citedby><cites>FETCH-LOGICAL-c572t-355f10030e3f6a24e61e73128423d5b61ec648caf0f060c53553e3863fdb22bd3</cites><orcidid>0000-0003-1317-4782</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33589728$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mat Bah, Mohd Nizam</creatorcontrib><creatorcontrib>Tan, Racine Yuh Hwa</creatorcontrib><creatorcontrib>Razak, Hasliza</creatorcontrib><creatorcontrib>Sapian, Mohd Hanafi</creatorcontrib><creatorcontrib>Abdullah, Nisah</creatorcontrib><creatorcontrib>Alias, Emieliyuza Yusnita</creatorcontrib><title>Survival and associated risk factors for mortality among infants with persistent pulmonary hypertension of the newborn in Malaysia</title><title>Journal of perinatology</title><addtitle>J Perinatol</addtitle><addtitle>J Perinatol</addtitle><description>Objective
This study aims to determine the immediate outcome of persistent pulmonary hypertension of the newborn (PPHN) and risk factors for mortality in the era of inhaled nitric oxide (iNO).
Study design
This observational cross-sectional study includes 195 confirmed PPHN with a gestational age of ≥34 weeks without congenital heart disease. Multivariable logistic regression was used to identify risk factors for mortality.
Results
The mortality rate was 16.4%, with the highest mortality with pulmonary hypoplasia. Of 195, 65% received iNO; 18% were iNO non-responders with the majority having pulmonary hypoplasia. Independent risk factors for mortality were the presence of reversal of flow at the descending aorta, pulmonary hypoplasia, APGAR scores ≤ 5 at 5 min, and idiopathic PPHN with an adjusted odds ratio of 15.9, 7.5, 6.7, and 6.4, respectively.
Conclusions
Despite the usage of iNO, mortality due to PPHN remains high and is related to etiology and cardiac function.</description><subject>692/308/409</subject><subject>692/499</subject><subject>Administration, Inhalation</subject><subject>Aorta</subject><subject>Apgar score</subject><subject>Cardiovascular diseases</subject><subject>Care and treatment</subject><subject>Coronary artery disease</subject><subject>Etiology</subject><subject>Gestational age</subject><subject>Heart diseases</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension, Pulmonary - drug therapy</subject><subject>Hypoplasia</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Malaysia - epidemiology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Newborn babies</subject><subject>Nitric oxide</subject><subject>Nitric Oxide - therapeutic use</subject><subject>Patient outcomes</subject><subject>Pediatric research</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Persistent Fetal Circulation Syndrome - drug therapy</subject><subject>Persistent Fetal Circulation Syndrome - epidemiology</subject><subject>Pulmonary hypertension</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><issn>0743-8346</issn><issn>1476-5543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9ks1rFDEYxgdR7Lb6D3iQgFB6mZrvyV6EUvyCigf1HDKZZCc1k6xJZste_cvNurXtisgcwrzv73mSvHma5gWC5wgS8TpTRDrcQoxaCJcct_xRs0C04y1jlDxuFrCjpBWE8qPmOOdrCHfN7mlzRAgTyw6LRfPzy5w2bqM8UGEAKueonSpmAMnl78AqXWLKwMYEppiK8q5sgZpiWAEXrAolgxtXRrA2KbtcTChgPfvaV2kLxm0t11p2MYBoQRkNCOamjylUNfikvNpmp541T6zy2Ty_XU-ab-_efr380F59fv_x8uKq1azDpSWMWQQhgYZYrjA1HJmOICwoJgPr65_mVGhloYUcalZ5YojgxA49xv1ATpo3e9_13E9m0PWwSXm5Tm6qp5VROXnYCW6Uq7iRnRBkyWk1OLs1SPHHbHKRk8vaeK-CiXOWmC4hwlRAVtFXf6HXcU6hXk9ihvCSQ8ToPbVS3sg60Fj31TtTecGZ4LAThFfq_B9U_QYzOR2Dsa7WDwSnDwSjUb6MOfq51HfIhyDegzrFnJOxd8NAUO4iJvcRkzVi8nfE5E708uEY7yR_MlUBsgdybYWVSfd3_4_tLxJX3Tk</recordid><startdate>20210401</startdate><enddate>20210401</enddate><creator>Mat Bah, Mohd Nizam</creator><creator>Tan, Racine Yuh Hwa</creator><creator>Razak, Hasliza</creator><creator>Sapian, Mohd Hanafi</creator><creator>Abdullah, Nisah</creator><creator>Alias, Emieliyuza Yusnita</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1317-4782</orcidid></search><sort><creationdate>20210401</creationdate><title>Survival and associated risk factors for mortality among infants with persistent pulmonary hypertension of the newborn in Malaysia</title><author>Mat Bah, Mohd Nizam ; Tan, Racine Yuh Hwa ; Razak, Hasliza ; Sapian, Mohd Hanafi ; Abdullah, Nisah ; Alias, Emieliyuza Yusnita</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c572t-355f10030e3f6a24e61e73128423d5b61ec648caf0f060c53553e3863fdb22bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>692/308/409</topic><topic>692/499</topic><topic>Administration, Inhalation</topic><topic>Aorta</topic><topic>Apgar score</topic><topic>Cardiovascular diseases</topic><topic>Care and treatment</topic><topic>Coronary artery disease</topic><topic>Etiology</topic><topic>Gestational age</topic><topic>Heart diseases</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension, Pulmonary - drug therapy</topic><topic>Hypoplasia</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Malaysia - epidemiology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Newborn babies</topic><topic>Nitric oxide</topic><topic>Nitric Oxide - therapeutic use</topic><topic>Patient outcomes</topic><topic>Pediatric research</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Persistent Fetal Circulation Syndrome - drug therapy</topic><topic>Persistent Fetal Circulation Syndrome - epidemiology</topic><topic>Pulmonary hypertension</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mat Bah, Mohd Nizam</creatorcontrib><creatorcontrib>Tan, Racine Yuh Hwa</creatorcontrib><creatorcontrib>Razak, Hasliza</creatorcontrib><creatorcontrib>Sapian, Mohd Hanafi</creatorcontrib><creatorcontrib>Abdullah, Nisah</creatorcontrib><creatorcontrib>Alias, Emieliyuza Yusnita</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of perinatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mat Bah, Mohd Nizam</au><au>Tan, Racine Yuh Hwa</au><au>Razak, Hasliza</au><au>Sapian, Mohd Hanafi</au><au>Abdullah, Nisah</au><au>Alias, Emieliyuza Yusnita</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Survival and associated risk factors for mortality among infants with persistent pulmonary hypertension of the newborn in Malaysia</atitle><jtitle>Journal of perinatology</jtitle><stitle>J Perinatol</stitle><addtitle>J Perinatol</addtitle><date>2021-04-01</date><risdate>2021</risdate><volume>41</volume><issue>4</issue><spage>786</spage><epage>793</epage><pages>786-793</pages><issn>0743-8346</issn><eissn>1476-5543</eissn><abstract>Objective
This study aims to determine the immediate outcome of persistent pulmonary hypertension of the newborn (PPHN) and risk factors for mortality in the era of inhaled nitric oxide (iNO).
Study design
This observational cross-sectional study includes 195 confirmed PPHN with a gestational age of ≥34 weeks without congenital heart disease. Multivariable logistic regression was used to identify risk factors for mortality.
Results
The mortality rate was 16.4%, with the highest mortality with pulmonary hypoplasia. Of 195, 65% received iNO; 18% were iNO non-responders with the majority having pulmonary hypoplasia. Independent risk factors for mortality were the presence of reversal of flow at the descending aorta, pulmonary hypoplasia, APGAR scores ≤ 5 at 5 min, and idiopathic PPHN with an adjusted odds ratio of 15.9, 7.5, 6.7, and 6.4, respectively.
Conclusions
Despite the usage of iNO, mortality due to PPHN remains high and is related to etiology and cardiac function.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>33589728</pmid><doi>10.1038/s41372-021-00962-6</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1317-4782</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of perinatology, 2021-04, Vol.41 (4), p.786-793 |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | 692/308/409 692/499 Administration, Inhalation Aorta Apgar score Cardiovascular diseases Care and treatment Coronary artery disease Etiology Gestational age Heart diseases Humans Hypertension Hypertension, Pulmonary - drug therapy Hypoplasia Infant Infant, Newborn Infants Malaysia - epidemiology Medicine Medicine & Public Health Mortality Newborn babies Nitric oxide Nitric Oxide - therapeutic use Patient outcomes Pediatric research Pediatric Surgery Pediatrics Persistent Fetal Circulation Syndrome - drug therapy Persistent Fetal Circulation Syndrome - epidemiology Pulmonary hypertension Risk analysis Risk Factors |
| title | Survival and associated risk factors for mortality among infants with persistent pulmonary hypertension of the newborn in Malaysia |
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