title: Persistent Pulmonary Hypertension of the Newborn in Late Preterm and Term Infants in California.
abstract: There are limited epidemiologic data on persistent pulmonary hypertension of the newborn (PPHN). We sought to describe the incidence and 1-year mortality of PPHN by its underlying cause, and to identify risk factors for PPHN in a contemporary population-based dataset.
  
  
  
  The California Office of Statewide Health Planning and Development maintains a database linking maternal and infant hospital discharges, readmissions, and birth and death certificates from 1 year before to 1 year after birth. We searched the database (2007-2011) for cases of PPHN (identified by International Classification of Diseases, Ninth Revision codes), including infants ≥34 weeks' gestational age without congenital heart disease. Multivariate Poisson regression was used to identify risk factors associated with PPHN; results are presented as risk ratios, 95% confidence intervals.
  
  
  
  Incidence of PPHN was 0.18% (3277 cases/1 781 156 live births). Infection was the most common cause (30.0%). One-year mortality was 7.6%; infants with congenital anomalies of the respiratory tract had the highest mortality (32.0%). Risk factors independently associated with PPHN included gestational age <37 weeks, black race, large and small for gestational age, maternal preexisting and gestational diabetes, obesity, and advanced age. Female sex, Hispanic ethnicity, and multiple gestation were protective against PPHN.
  
  
  
  This risk factor profile will aid clinicians identifying infants at increased risk for PPHN, as they are at greater risk for rapid clinical deterioration.
authors.affiliation: Departments of Pediatrics and steurermullerm@peds.ucsf.edu.|Epidemiology and Biostatistics, and.
authors.forename: Martina A
authors.initials: MA
authors.lastname: Steurer
authors.affiliation: Epidemiology and Biostatistics, and.|California Preterm Birth Initiative, University of California, San Francisco, California; and.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Jelliffe-Pawlowski
authors.affiliation: California Preterm Birth Initiative, University of California, San Francisco, California; and.|Department of Pediatrics, University of California, San Diego, California.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Baer
authors.affiliation: Departments of Pediatrics and.
authors.forename: J Colin
authors.initials: JC
authors.lastname: Partridge
authors.affiliation: Departments of Pediatrics and.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Rogers
authors.affiliation: Departments of Pediatrics and.
authors.forename: Roberta L
authors.initials: RL
authors.lastname: Keller
mesh_terms: D002140:California; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D005865:Gestational Age; D006753:Hospital Records; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D015996:Survival Rate