Prevalence and Clinical Correlates of Persistent Pulmonary Hypertension of the Newborn in Neonates With Perinatal Asphyxia at Kenyatta National Hospital – Newborn Unit (KNH-NBU)

Abstract

Introduction Perinatal asphyxia is the inability to start or maintain breathing after birth. Globally around 9 million cases of perinatal asphyxia are reported annually and in Kenya, it accounts for 29% of neonatal mortalities. This is a major risk factor for developing Persistent Pulmonary Hypertension of the Newborn (PPHN) as hypoxia and ischemia lead to an increase in PVR and both are associated with MAS. Severe PPHN in asphyxia can lead to higher mortality rates and longer hospital stays. Since PPHN is a treatable condition, early diagnosis can improve the outcomes in asphyxiated neonates. Echocardiography can be effectively used to diagnose PPHN by estimating mPAP. Objective To determine the prevalence of PPHN in neonates with birth asphyxia at KNH-NBU. Methodology A hospital-based prospective observational study among neonates with moderate to severe asphyxia admitted to the KNH-NBU. 49 neonates were recruited into the study. Echocardiography was performed to diagnose and determine the severity of PPHN. Data analysis Data was entered and analyzed using The R version 4.1.2. Continuous variables were presented in summary form using means and standard deviation. The Fishers exact test of association was used to compare the categorical variables. Ethical considerations Consent was obtained from the KNH-UoN Ethics committee. The ECHO findings were communicated to the attending doctor in real-time for better management of the patients. Results Out of 49 neonates 26 were found to have PPHN. In multivariate analysis Meconium stained liquor, Male gender and cesarean section delivery were found to be significant risk factors for developing PPHN in neonates with asphyxia. Conclusions The prevalence of PPHN was found to be high (53%) in the neonates with perinatal asphyxia. Asphyxiated Neonates born through meconium stained liquor were having higher risk for developing PPHN