Child Health Status

Child Health Status 

Introduction: Infants with persistent pulmonary hypertension of the newborn (PPHN) are at increased risk for pulmonary morbidity, hearing and speech loss, cerebral palsy, seizures, stroke, and developmental delay. Inhaled nitric oxide has been recently reported to be effective in the treatment of PPHN. A randomized, controlled trial was performed to determine the effectiveness of nitric oxide for PPHN. Health and neurodevelopmental outcome variables and parental satisfaction with hospital care were assessed.

Methods: Between September 1992 and January 1997, 83 infants and children, aged 1 to 4 years, were randomized to receive either conventional therapy (40) or conventional therapy plus nitric oxide (43). Outcome variables were evaluated by telephone interview and standardized questionnaires. Parental report of specific conditions and hospital use, rating of general health, cognitive and motor development, behavior problems, temperament, and satisfaction with the hospital stay were assessed.

Results: Complete interview data were available in 60 (72%) of  83 survivors. No postdischarge deaths were recorded. Race, income, parental education, entry oxygenation index, extracorporeal oxygenation use, and days of hospitalization were similar for both groups. No between-group differences were noted in any pulmonary, neurologic, cognitive, behavioral, or neurosensory outcome variables; hospital readmission rates; or parental ratings of a child's health. Rates of overall neurologic handicap, hearing deficit, and behavioral problems were 15%, 7%, and 26%, respectively. Satisfaction rates were high for both groups. Both groups had similar parental ratings.

Conclusion: No adverse health or neurodevelopmental outcomes were seen among infants treated with nitric oxide for PPHN. Enrollment in either group of the study did not appear to affect parental satisfaction with the hospital care that their child received.