Temporal Onset and Duration of Pulmonary Haemorrhage – Impact on Survival Outcomes in Neonates

Introduction: Pulmonary haemorrhage is a catastrophic neonatal condition associated with extremely high mortality. The timing of onset and duration of bleeding play crucial roles in determining outcomes. The present study aimed to evaluate the impact of temporal onset and duration of pulmonary haemorrhage on survival outcomes in neonates. Methods & Materials: This prospective cohort study was conducted at Bangladesh Shishu Hospital & Institute, Dhaka, from July 2019 to June 2021. Seventy neonates (gestational age 28–42 weeks) who developed pulmonary haemorrhage during hospitalisation were enrolled. Demographic, clinical, and temporal data were recorded. Survival outcomes were compared between survivors (n=8) and non-survivors (n=62) using the unpaired Student’s t-test and Fisher’s Exact test. Statistical analysis was performed using SPSS version 22.0. Results: Mortality was 88.5%. Survivors had significantly earlier onset of haemorrhage (3.00 ± 1.69 days) compared with non-survivors (8.12 ± 7.07 days; p=0.046). Similarly, onset during hospitalisation was earlier (3.37 ± 1.18 days vs. 6.64 ± 3.44 days; p=0.007), and duration was markedly shorter in survivors (4.50 ± 0.53 h vs. 9.48 ± 0.56 h; p=0.001). Clinical appearance differed significantly (p=0.044), with dyspneic presentations dominating among survivors, whereas lethargy predominated in deaths. Conclusion: Temporal variables—particularly early onset and shorter duration—are strong survival predictors in neonatal pulmonary haemorrhage. Prompt recognition and early hemostatic intervention within the first few hours are crucial for improving prognosis and guiding clinical management.