Neonatal-Perinatal Risk Factors for the Development of Persistent Pulmonary Hypertension of the Newborn in Preterm Newborns

Jonathan K. Muraskas; Linda J. Juretschke; Marc G. Weiss; Monika Bhola; Richard E. Besinger

doi:10.1055/s-2001-13638

American Journal of Perinatology, Table of Contents

Am J Perinatol 2001; 18(2): 087-092
DOI: 10.1055/s-2001-13638

ORIGINAL ARTICLES

Neonatal-Perinatal Risk Factors for the Development of Persistent Pulmonary Hypertension of the Newborn in Preterm Newborns

Jonathan K. Muraskas¹ , Linda J. Juretschke² , Marc G. Weiss¹ , Monika Bhola¹ , Richard E. Besinger³

¹Division of Neonatology, Loyola University Medical Center, Maywood, Illinois
²Department of Nursing, Ronald McDonald Children's Hospital, Loyola University Medical Center, Maywood, Illinois
³Division of Maternal-Fetal Medicine, Loyola University Medical Center, Maywood, Illinois

Abstract

ABSTRACT

There is a long-held belief that preterm newborns lack sufficient arteriolar musculature to maintain a prolonged elevated pulmonary vascular resistance (PVR) after birth. Net ductal flow is thought to be minimal, with the developing pulmonary circulation incapable of significant vasoconstriction. We identified retrospectively 15 premature newborns over a 10-year period weighing ≤1500 g and with a gestational age of ≤30 weeks with documented persistent pulmonary hypertension of the newborn (PPHN) in the first 24 hours after birth. We matched 36 newborns of similar weight and gestation with no clinical evidence of shunting. The control group weaned to an FiO₂ ≤0.50 by 12 hours after birth. Despite similar gestational ages, the PPHN group (n = 15) had significantly higher birth weights than the control group (n = 36). The duration of ruptured membranes, maternal tobacco use, and use of antenatal steroids were significantly higher in the PPHN group. We speculate that these three factors might act in a synergistic relationship with which to accelerate pulmonary vascular smooth muscle development in premature newborns.

KEYWORD

Persistent pulmonary hypertension of the newborn - pulmonary vascular resistance - antenatal steroids - prolonged premature rupture of the membranes - maternal tobacco use

Full Text

References

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