Multivariate Analysis of Prognostic Factors in Persistent Pulmonary Hypertension of the Newborn (PPHN)

Persistent Pulmonary Hypertension of the Newborn (PPHN) is a life-threatening disorder characterized by pathologically elevated pulmonary vascular resistance and severe hypoxemia, with mortality rates ranging from 5–10% ^1,2 . Its pathogenesis involves pulmonary vascular remodeling and abnormal vasoconstriction. This retrospective study analyzed 162 PPHN neonates admitted between July 2017 and October 2024 to identify independent prognostic risk factors. Using LASSO regression for variable selection and multivariate logistic regression modeling, the results demonstrated:Birth asphyxia (OR = 3.73, 95% CI: 1.31–11.45) and invasive mechanical ventilation (OR = 4.41, 95% CI: 1.14–22.54) were independent risk factors for poor prognosis。Right-to-left shunting through a patent ductus arteriosus showed a trend toward poor prognosis (OR = 4.63, 95% CI: 0.53–62.51), but the wide confidence interval necessitates validation with larger cohorts.Low-molecular-weight heparin (LMWH) therapy exhibited a significant negative correlation with adverse outcomes (OR = 0.27, 95% CI: 0.05–1.09), suggesting a protective effect, though limited by small sample size (n = 45).Prolonged hospitalization (OR = 0.19, 95% CI: 0.07–0.43) may reflect treatment complexity and requires adjustment for disease severity.Further analysis highlighted that lung-protective ventilation strategies (low tidal volume, moderate PEEP) improved oxygenation and reduced lung injury risks. This study provides evidence-based insights for early risk stratification and individualized PPHN management. Future multicenter randomized controlled trials are warranted to validate LMWH efficacy and explore biomarker-guided precision therapies.