Is there an association between maternal perinatal and antenatal Coronavirus Disease 2019 (COVID-19) infection and the development of Persistent Pulmonary Hypertension of the Newborn (PPHN) in offspring?

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Last updated: February 13, 2025 • View editorial policy

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From the Research

Association between Maternal COVID-19 Infection and PPHN in Offspring

  • There is evidence to suggest that maternal COVID-19 infection may be associated with an increased risk of adverse perinatal outcomes, including PPHN in offspring 1, 2, 3, 4, 5.
  • A systematic review of 21 articles found that COVID-19 in neonates with PPHN was commonly associated with severe illness, ICU admission, ARDS, and MIS-N 1.
  • Another study found that severe forms of COVID-19 in pregnant women increased the risk of premature delivery, cesarean section, admission to the ICU, and maternal death 2.
  • A retrospective analytical cohort study found that COVID-19 in pregnancy was associated with a significantly higher risk of admission to the ICU, caesarean section, preterm birth, fetal distress, and admission to the NICU 4.
  • The INTERCOVID Multinational Cohort Study found that COVID-19 in pregnancy was associated with increased maternal and neonatal complications, including preterm birth and lower neonatal weight, length, and head circumference at birth 5.

Risk Factors for PPHN in Offspring of Mothers with COVID-19 Infection

  • Gestational age at diagnosis, birthweight, and maternal ventilatory support were independently associated with composite adverse fetal outcome, including PPHN 3.
  • The length of in utero exposure to COVID-19 was significantly correlated to the risk of the neonate testing positive for COVID-19 5.
  • Cesarean delivery was a risk factor for testing positive for COVID-19 in neonates born to mothers with COVID-19 diagnosis 5.
  • Male neonates with PPHN and COVID-19, and those requiring prolonged invasive positive pressure ventilation, showed an increased relative risk for death 1.

Clinical Characteristics and Outcomes of Neonates with PPHN and COVID-19

  • Neonates with PPHN and COVID-19 commonly experienced acute respiratory distress syndrome (ARDS) and multisystem inflammatory syndrome in neonates (MIS-N) 1.
  • A high proportion of neonates with PPHN and COVID-19 were admitted to the ICU or needed mechanical ventilation 1.
  • Neonates with PPHN and COVID-19 who died had worse severity of COVID-19, including critical illness and need for more antibiotics 1.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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