Abstract:

Background: Persistent pulmonary hypertension of the newborn is a complication that occurs when there’s feta-neonatal transition failure. If left not treated may cause chronic lung disease, neurological disorders, cognitive impairment, and even death. Little is known about this condition in our resource-limited setting.

Objective: To determine the prevalence, factors associated with persistent pulmonary hypertension and diagnostic utility of differential oxygen saturation among newborn babies in Mwanza, Tanzania

Methodology: A cross-sectional study conducted from August 2022 to April 2023. About 860 newborn babies were enrolled by randomly convenient sampling technique. Data on the differential oxygen saturation and echocardiography findings were documented. We included all newborns from 1 to 28 days of life and those with major congenital anomalies were excluded. STATA version-13 was used for analysis and the receiver operating curve was used to assess the diagnostic utility of differential oxygen saturation. the p-value of less than 0.05 at a 95% confidence interval was considered statistically significant.

Results: The prevalence of persistent pulmonary hypertension in the newborn was found to be 6.2%; cesarean section, meconium aspiration, and respiratory distress were significantly associated factors having odd ratios of 1.99, 5.8, and 2.66 respectively. The area under the curve for differential oxygen saturation was 0.8903. At the cutpoint of 5% sensitivity, specificity, positive and negative predictive values were 75.47%, 89.47%, 16.82% and 99.2% respectively. At the cutpoint of 10% sensitivity, specificity, positive and negative predictive values were 41.51%, 98.64%, 4.47% and 100% respectively.

Conclusion: Our findings show that, there is a high prevalence of persistent pulmonary hypertension among newborn babies in our setting. At-risk newborn babies were those born at term or near term, delivered by cesarean section, and present with respiratory distress or meconium aspiration. A differential oxygen saturation of <5% is normal, between 5% to 10% suspect, and needs echocardiography to confirm before any interventions, while a differential saturation of 10% or more strongly suggests persistent pulmonary hypertension of the newborn and interventions can be started while waiting for echocardiography.