Clinical profile, survival outcomes, and predictors of mortality in neonates with persistent pulmonary hypertension: a follow-up study from Hawassa, Ethiopia
Abstract
INTRODUCTION: Persistent pulmonary hypertension of the newborn (PPHN) is a failure of normal fetal-to-neonatal circulatory transition. Evidence from low-resource settings remains limited. This study evaluated clinical characteristics, treatment outcomes, mortality predictors, and time to clinical and echocardiographic resolution among neonates with PPHN at a tertiary hospital in Hawassa, Ethiopia. METHODOLOGY: A retrospective follow-up study was conducted from July 1 to September 30, 2025, among 115 neonates admitted to the NICU of Hawassa University Comprehensive Specialized Hospital with PPHN diagnosed between June 2022 and June 2025. Clinical profiles were described using frequencies and percentages. Kaplan–Meier survival analysis and log-rank tests compared survival between severe and non-severe PPHN. Cox proportional hazards modeling identified predictors of mortality. Mann–Whitney U tests assessed differences in time to clinical and echocardiographic resolution. RESULTS: Of 115 neonates, 26.1% were delivered by cesarean section, 55.7% were term, and 51.3% had normal birth weight. Common etiologies included early-onset neonatal sepsis (74.8%), meconium aspiration syndrome (55.7%), and respiratory distress syndrome (30.4%). Severe PPHN, initially managed with sildenafil, was present in 89.6% of neonates; 20.9% required a saline bolus, and 20% required inotropic support. Over a median follow-up of 38 days (IQR: 8–45), mortality was 28.7%. Predictors of mortality included…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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