Outcomes of infants with hypoxic ischemic encephalopathy and persistent pulmonary hypertension of the newborn: results from three NICHD studies.

Abstract

OBJECTIVE:

To determine the association of persistent pulmonary hypertension of the newborn (PPHN) with death or disability among infants with moderate or severe hypoxic ischemic encephalopathy (HIE) treated with therapeutic hypothermia.

METHODS:

We compared infants with and without PPHN enrolled in the hypothermia arm from three randomized controlled trials (RCTs): Induced Hypothermia trial, "usual care" arm of Optimizing Cooling trial, and Late Hypothermia trial. Primary outcome was death or disability at 18-22 months adjusted for severity of HIE, center, and RCT.

RESULTS:

Among 280 infants, 67 (24%) were diagnosed with PPHN. Among infants with and without PPHN, death or disability was 47% vs. 29% (adjusted OR: 1.65, 0.86-3.14) and death was 26% vs. 12% (adjusted OR: 2.04, 0.92-4.53), respectively.

CONCLUSIONS:

PPHN in infants with moderate or severe HIE was not associated with a statistically significant increase in primary outcome. These results should be interpreted with caution given the limited sample size.

• Authors: Prashant Agarwal, Seetha Shankaran, Abbot R Laptook, Dhuly Chowdhury, Satyan Lakshminrusimha, Sonia Lomeli Bonifacio, Girija Natarajan, Sanjay Chawla, Martin Keszler, Roy J Heyne, Namasivayam Ambalavanan, Michele C Walsh, Abhik Das, Krisa P Van Meurs, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network
• Journal: Journal of perinatology : official journal of the California Perinatal Association (J Perinatol) Vol. 41 Issue 3 Pg. 502-511 (03 2021) ISSN: 1476-5543 [Electronic] United States
• PMID: 33402707 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Topics

• Humans
• Hypertension, Pulmonary (etiology, therapy)
• Hypothermia, Induced
• Hypoxia-Ischemia, Brain (therapy)
• Infant
• Infant, Newborn
• National Institute of Child Health and Human Development (U.S.)
• Persistent Fetal Circulation Syndrome (complications, therapy)
• United States