Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Persistent pulmonary hypertension of the newborn (PPHN) is a critical condition with high mortality and morbidity rates in neonatal intensive care unit (NICU) admitted neonates due to severe hypoxemia. Objective:To evaluaterelationship between red cell distribution width (RDW) and PPHN as a biomarker of hypoxemia and determine the optimal cutoff point of RDW for identifying neonates with PPHN. Methods: This study is a case{u2013}control study that has been carried out in NICU of Cairo University children{u2019}s hospital, during the period from 1 December 2018 till 31 May 2019.Twenty five full-term newborns with diagnosis of PPHN who were admitted to the NICU, soon after birth, were included as the case group and 25 healthy term infants with unconjugated hyperbilirubinemia without hemolysis, who were admitted only for phototherapy, were included as control group Results: Regarding oxygen saturation and RDW, there was significant difference between case group and control group (96.1 ± 1.4 vs 97.2 ± 1.1 ; p = 0.005 and 18.3 ± 2.0 vs 15.0 ± 1.2; p <0.0001 respectively).Alsothere is moderate negative correlation between oxygen saturation and RDWin the whole study population (r = -0.408, P = 0.003) and moderate positive correlation between RDW and estimated pulmonary artery pressure (PAP)in the whole study population (r = 0.589, P <0.001).Receiver-operating characteristic (ROC) curve analysis was used to test the predictive value of RDW for discrimination between patients with or without PPHN. This analysis showed that RDW has excellent diagnostic value for PPHN with an area under the ROC curve (AUC) of 0.929 (P <0.0001).The optimal RDW cut point for prediction of PPHN by the ROC curve analysis was >16 (a sensitivity of 96% and specificity of 84%)

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