MECHANISMS UNDERLYING THE DEVELOPMENT OF PERSISTENT PULMONARY HYPERTENSION OF THE NEWBORN ASSOCIATED WITH MATERNAL PREECLAMPSIA: A CLINICAL CASE REPORT

Persistent pulmonary hypertension of the newborn (PPHN) is a severe complication of impaired postnatal hemodynamic adaptation, characterized by profound hypoxemia and a high risk of mortality. Maternal preeclampsia is recognized as a significant risk factor for PPHN, with its incidence potentially exacerbated by chronic psychoemotional stress. In the context of the full-scale war in Ukraine, heightened societal stress among pregnant women may play a critical role in the pathogenesis of cardiovascular disorders in neonates. Objective. To investigate the potential mechanisms contributing to the development of pulmonary hypertension in a neonate born to a mother with preeclampsia by correlating clinical case data with current literature. Materials and Methods. This study presents a clinical case analysis. A comprehensive diagnostic approach included maternal psychological assessment using standardized psychometric instruments (the Spielberger–Hanin Anxiety Inventory and the Hospital Anxiety and Depression Scale [HADS]), alongside clinical and laboratory evaluations, Doppler echocardiography, and cranial ultrasonography. The research was conducted in accordance with ethical standards for human medical research. Results and Discussion. The case describes a term neonate with a patent ductus arteriosus and patent foramen ovale, presenting with persistent fetal circulation syndrome and severe pulmonary hypertension. This condition reflects abnormal postnatal hemodynamic adaptation, likely associated with maternal hypertensive disorders during pregnancy and endothelial dysfunction. Psychological screening of the mother with preeclampsia revealed high levels of both state and trait anxiety (Spielberger–Hanin scales), as well as elevated anxiety scores in the absence of clinically significant depression (HADS), suggesting substantial psychoemotional stress. Conclusions. This clinical case underscores the development of PPHN in a term neonate born to a mother with severe preeclampsia during a period of sustained psychoemotional stress associated with the war in Ukraine. Key pathogenic mechanisms likely include placental insufficiency, chronic intrauterine hypoxia, endothelial dysfunction, impaired production of vasoactive substances, and antenatal exposure to a high-stress environment.