Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;41(4):794-800.
doi: 10.1038/s41372-021-00943-9. Epub 2021 Feb 15.

The use of supplemental hydrocortisone in the management of persistent pulmonary hypertension of the newborn

Samia Aleem  1 , Cliff Robbins  2 , Brianna Murphy  2 , Stephen Elliott  2 , Christiana Akinyemi  2 , Nicholas Paredes  2 , Veeral N Tolia  3   4 , Kanecia O Zimmerman  1   2 , Ronald N Goldberg  1 , Daniel K Benjamin  5 , Rachel G Greenberg  6   7
Affiliations

The use of supplemental hydrocortisone in the management of persistent pulmonary hypertension of the newborn

Samia Aleem et al. J Perinatol. 2021 Apr.

Abstract

Objective: Characterize association between hydrocortisone receipt and hospital outcomes of infants with persistent pulmonary hypertension of the newborn (PPHN).

Study design: Cohort study of infants ≥34 weeks with PPHN who received inhaled nitric oxide at <7 days of age (2010-2016). We generated propensity scores, and performed inverse probability-weighted regression to estimate hydrocortisone effect on outcomes: death, chronic lung disease (CLD), oxygen at discharge.

Results: Of 2743 infants, 30% received hydrocortisone, which was associated with exposure to mechanical ventilation, sedatives, paralytics, or vasopressors (p < 0.001). There was no difference in death, CLD, or oxygen at discharge. In infants with meconium aspiration syndrome, hydrocortisone was associated with decreased oxygen at discharge (odds ratio 0.56; 95% confidence interval 0.21, 0.91).

Conclusions: There was no association between hydrocortisone receipt and death, CLD, or oxygen at discharge in our cohort. Prospective studies are needed to evaluate the effectiveness of hydrocortisone in infants with PPHN.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: RGG has received support from industry for research services (https://dcri.org/about-us/conflict-of-interest/). The other authors have no conflicts of interest relevant to this article to disclose.

Figures

Figure 1.
Figure 1.
Percentage of infants with PPHN receiving hydrocortisone, by year. PPHN, persistent pulmonary hypertension of the newborn
See this image and copyright information in PMC

References

    1. Fuloria M, Aschner JL. Persistent pulmonary hypertension of the newborn. Semin Fetal Neonatal Med. 2017;22:220–6. - PubMed
    1. Walsh-Sukys MC, Tyson JE, Wright LL, Bauer CR, Korones SB, Stevenson DK, et al. Persistent pulmonary hypertension of the newborn in the era before nitric oxide: practice variation and outcomes. Pediatrics. 2000;105:14–20. - PubMed
    1. Roberts JD Jr., Fineman JR, Morin FC 3rd, Shaul PW, Rimar S, Schreiber MD, et al. Inhaled nitric oxide and persistent pulmonary hypertension of the newborn. The Inhaled Nitric Oxide Study Group. N Engl J Med. 1997;336:605–10. - PubMed
    1. Clark RH, Kueser TJ, Walker MW, Southgate WM, Huckaby JL, Perez JA, et al. Low-dose nitric oxide therapy for persistent pulmonary hypertension of the newborn. Clinical Inhaled Nitric Oxide Research Group. N Engl J Med. 2000;342:469–74. - PubMed
    1. Neonatal Inhaled Nitric Oxide Study G. Inhaled nitric oxide in full-term and nearly full-term infants with hypoxic respiratory failure. N Engl J Med. 1997;336:597–604. - PubMed

Publication types