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ORIGINAL ARTICLE
Year : 2020  |  Volume : 9  |  Issue : 4  |  Page : 242-248

Risk factor analysis of persistent pulmonary hypertension of the newborn in meconium aspiration syndrome in Thai neonates


Department of Pediatrics, Hat Yai Medical Education Center, Hat Yai Hospital, Hat Yai, Songkhla, Thailand

Correspondence Address:
Narongsak Nakwan
Department of Pediatrics, Neonatal Intensive Care Unit, Hat Yai Medical Education Center, Hat Yai Hospital, Hat Yai, Songkhla 90110
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcn.JCN_118_19

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Background: Meconium aspiration syndrome (MAS)-associated persistent pulmonary hypertension of the newborn (PPHN) is a serious respiratory disease in neonates. Objective: The objective was to examine the risk factors and outcomes of MAS-associated PPHN (MAS-PPHN). Patients and Methods: The records of neonates diagnosed with MAS with and without PPHN at Hat Yai Hospital from January 2015 to December 2017 were retrospectively reviewed. Results: During the study period, the cases of 211 MAS neonates were analyzed. The overall incidence of MAS based on born inside hospital was 7.7 per 1000 live births. Of these, 36 (17.1%) developed PPHN with a 2.4% (5/211) mortality rate. The mean gestational age and birth weight of all MAS neonates were 39.2 ± 1.6 weeks and 3043 ± 584 g, respectively. MAS-PPHN neonates had a significantly lower Apgar score at 5 min of <7 (33.3 vs. 18.3%, P = 0.04) compared with those who did not develop PPHN. Severe MAS was found to be a significant predictor of PPHN in the neonates with MAS (adjusted odds ratio [OR] = 96.5). In a multivariate analysis, lowest mean arterial blood pressure (MBP) of <35 mmHg within 12 h of admission, initial positive end expiratory pressure of ≥6 cmH2O (adjusted OR = 15.1), and initial supplemental fraction of inspired oxygen (FiO2) of ≥0.6 (adjusted OR = 22.2) were found to be independent indicators for developing PPHN in MAS. Conclusions: Lower MBP within 12 h of admission was a significant risk indicator for potential PPHN in MAS in this study.


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