Risk Factors for Persistent Pulmonary Hypertension of the Newborn

Hernández–Dı́az, Sonia; Marter, Linda J. Van; Werler, Martha M.; Louik, Carol; Mitchell, Allen A.

doi:10.1542/peds.2006-3037

Cited by 173 publications

(144 citation statements)

References 31 publications

Supporting

Mentioning

123

Contrasting

Unclassified

Order By: Relevance

“…29 Those that were considered potential confounding factors in analyses of the relationships among analgesics and PPHN are presented in Table 2. Factors associated with increased risk of PPHN included maternal race/ethnicity (ie, Black or Asian), BMI .27, maternal diabetes mellitus or asthma, cesarean delivery, male infant gender, birth weight ,2500 or .4000 g, gestational age ,37 or .41 weeks, and large for gestational age designation.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Nonsteroidal Antiinflammatory Drugs in Late Pregnancy and Persistent Pulmonary Hypertension of the Newborn

2012

PEDIATRICS

View full text Add to dashboard Cite

WHAT'S KNOWN ON THIS SUBJECT: Knowledge is limited regarding the epidemiology of persistent pulmonary hypertension of the newborn (PPHN). Previous work has implicated a host of perinatal risk factors and a few antenatal antecedents of PPHN, including maternal consumption during pregnancy of nonsteroidal antiinflammatory medications. WHAT THIS STUDY ADDS:In contrast to results of previous studies, we found no association between PPHN and maternal consumption during late pregnancy of nonsteroidal antiinflammatory drugs in general or ibuprofen in particular. abstract OBJECTIVE: Persistent pulmonary hypertension of the newborn (PPHN) is a clinical syndrome of late-preterm and full-term infants associated with failure of the normal fetal-to-neonatal circulatory transition. This study was designed to test the hypothesis that risk for PPHN is increased after antenatal exposure to nonsteroidal antiinflammatory drugs (NSAIDs), with particular emphasis on late gestational exposures. METHODS:Between 1998 and 2003, we interviewed 377 women whose infants had PPHN and 836 control mothers of infants matched to cases by hospital and birth date. Interviews captured information on prescription and over-the-counter medication use in pregnancy as well as a variety of potential confounding factors. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for third-trimester maternal NSAID use were estimated by using multivariate conditional logistic regression. RESULTS:During the third trimester of gestation, 33 infants (8.8%) with PPHN were exposed to any NSAID compared with 80 (9.6%) controls (OR 0.8; 95% CI 0.5-1.3). We observed an elevated OR for PPHN risk among infants whose mothers consumed aspirin during the third-trimester; however, the lower 95% CI included the null. Neither nonaspirin NSAIDs at any time during pregnancy nor ibuprofen use during the third trimester was associated with an elevated risk of PPHN. Similarly, no association was observed between a mother' s third-trimester acetaminophen use and the occurrence of PPHN in her newborn.CONCLUSIONS: This large multicenter epidemiologic study of PPHN risk revealed no evidence to support the hypothesis that maternal consumption during pregnancy of NSAIDs overall or ibuprofen in particular is associated with PPHN risk. All authors made substantive intellectual contributions to this study; each has contributed sufficiently in the work to take public responsibility for appropriate portions of the content; and each has seen and approved the final submission version of the manuscript.www.pediatrics.org/cgi

show abstract

Section: Resultsmentioning

confidence: 99%

“…29,30 This method ensures more complete reporting 29,31 and allows linkage between all medications and occurrences of illnesses.…”

Section: Assessment Of Exposurementioning

confidence: 99%

Nonsteroidal Antiinflammatory Drugs in Late Pregnancy and Persistent Pulmonary Hypertension of the Newborn

2012

PEDIATRICS

View full text Add to dashboard Cite

show abstract

“…60 Cesarean delivery, late preterm, large for gestation age and maternal asthma might be also important risk factors for PPHN. 61 Pathophysiological mechanisms of PPHN have been investigated at the level of endothelial as well as smooth muscle function. 59 Functional changes in PPHN are primarily correlated with endothelial dysfunction, resulting in an imbalance between vasodilation and vasoconstriction.…”

Section: Pphn and Enosmentioning

confidence: 99%

Epigenetic regulation of pulmonary arterial hypertension

Cheng

2011

Hypertens Res

View full text Add to dashboard Cite

Pulmonary arterial hypertension (PAH) is diagnosed as a sustained elevation of pulmonary arterial pressure to more than 25 mm Hg at rest or to more than 30 mm Hg with exercise. PAH is an intrinsic disease of the pulmonary vascular smooth muscle and endothelial cells in association with plexiform lesions, medial thickening, concentric laminar intimal fibrosis and thrombotic lesions. Pulmonary vascular remodeling is the characteristic pathological change of PAH. The pathogenesis of PAH has been studied at the level of smooth muscle and endothelial cells. Existing research does not adequately explain susceptibility to the disease, and recent evidence reveals that epigenetic alterations may be involved in PAH. Epigenetics refers to all heritable changes in phenotype or in gene expression states, including chromatin remodeling, DNA methylation, histone modification and RNA interference, which are not involved in the DNA sequence itself. This review will focus on recent advances in epigenetics related to PAH, including epigenetic changes of superoxide dismutase, endothelial nitric oxide synthase and the bone morphogenetic protein signaling pathway. This will provide new insight for improved treatment and prevention of PAH. Future work aimed at specific epigenetic treatments may prove to be an effective therapy for patients with PAH.

show abstract

“…There are many studies which have found various risk factors associated with PPHN [2][3][4] which have been identified retrospectively. However there is paucity of data about the newborns who have one or more risk factors for PPHN and have some degrees of PAH not significant enough to cause hypoxemia and desaturation.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Pulmonary Arterial Hypertension on Echocardiography in Newborns with Maternal Risk factors

Abqari¹

2017

IPCB

View full text Add to dashboard Cite

Persistent pulmonary hypertension of newborn (PPHN) is suspected when the newborn has persistent desaturation and validated pulmonary hypertension and is associated with various risk factors both maternal and neonatal. The outcome of newborns with PPHN is always guarded even in good NICUs. This study was aimed at detection of PAH among newborns with maternal risk factors for PPHN. Twin delivery and newborns born through Caesarean section had higher prevalence of PAH but no significant association was found.

show abstract

Risk Factors for Persistent Pulmonary Hypertension of the Newborn

Cited by 173 publications

References 31 publications

Nonsteroidal Antiinflammatory Drugs in Late Pregnancy and Persistent Pulmonary Hypertension of the Newborn

Nonsteroidal Antiinflammatory Drugs in Late Pregnancy and Persistent Pulmonary Hypertension of the Newborn

Epigenetic regulation of pulmonary arterial hypertension

Prevalence of Pulmonary Arterial Hypertension on Echocardiography in Newborns with Maternal Risk factors

Contact Info

Product

Resources

About