Persistent pulmonary hypertension of the newborn, or PPHN, is a life-threatening breathing issue that occurs when your newborn doesn’t adapt to breathing outside of your uterus. PPHN happens when your baby’s pulmonary arteries don’t open up enough, so your baby’s brain and organs don’t get enough oxygen.
Persistent pulmonary hypertension of the newborn, or PPHN, is a serious breathing problem in newborns. It occurs when your newborn’s circulatory system doesn’t adapt to breathing outside of your uterus.
While in your uterus, the fetus gets oxygen through the umbilical cord and placenta. Very little blood goes to the fetal lungs because the blood vessels in the lungs (pulmonary arteries) are mostly closed. Blood bypasses the lungs and flows to the rest of the body.
After your baby is born and takes their first breath, the blood vessels of their lungs should open. Air brings oxygen into their lungs. The blood vessels then allow blood to travel to your baby’s lungs to get the oxygen and deliver it to the rest of their body.
PPHN happens when your newborn’s blood vessels don’t open up enough, which means there’s a limit on how much oxygen reaches your baby’s brain and other organs, such as their heart, kidneys and gut. PPHN is a life-threatening medical emergency that can happen shortly after birth.
PPHN occurs in 2 out of every 1,000 live births. It happens most often in full-term babies (born between 37 and 42 weeks) and late-term babies (born after 42 weeks). It occasionally occurs in premature babies, as well.
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Symptoms of PPHN may include:
Researchers don’t know the exact cause of PPHN. However, incorrectly developed or underdeveloped blood vessels in your baby’s lungs — or their inability to adapt (open up) to the outside environment — may cause the condition.
Although the cause is unknown, certain factors increase your infant’s risk of developing PPHN. These factors may include:
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Up to 1 in 4 babies who survive PPHN will have some impairment due to a lack of oxygen reaching their brains. These complications may include:
Your infant’s healthcare provider may use various laboratory and imaging tests to diagnose PPHN, including:
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The main goal of treatment for PPHN is to increase oxygen flow to your baby’s organs to prevent serious complications. Treatment may include a variety of options, including:
Researchers don’t know why the condition occurs, so you can’t prevent it. However, you can reduce your risk by avoiding certain medications during your pregnancy. Speak with your healthcare provider about which medicines are safe to take during pregnancy.
While most cases of PPHN resolve within one to two weeks, some may take longer, sometimes months to recover fully. It’ll be important to help protect your baby from catching colds, the flu and other viruses. You can help with this by practicing good handwashing and keeping your baby away from large crowds and people who are sick. It’ll also help to make sure all household members get their annual flu vaccine. It’ll be especially important for your baby to see their healthcare provider and other specialists regularly to be screened for normal developmental milestones.
Between 7% and 10% of newborns with PPHN will die due to complications of the condition. Of those that survive, 25% will experience lasting effects due to a lack of oxygen reaching their brain. These long-term effects may include developmental delays, learning disabilities and hearing problems.
Make sure to bring your baby to all of their follow-up appointments so their healthcare provider can continue to monitor them. In the meantime, seek immediate medical care if your baby:
A note from Cleveland Clinic
Learning your newborn has PPHN may bring on a range of emotions. It’s OK to feel sad, scared, angry or confused. Learning as much as you can about PPHN from your baby’s caregivers will help you feel more on top of things. They’ll teach you everything you need to know about what’s going on with your baby and how you can help comfort your newborn. Before long, you’ll be an expert on your baby’s condition and you’ll feel confident that you’re doing everything you can to help your baby survive and thrive.
Last reviewed on 05/15/2023.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy