Which adverse effect is commonly observed in neonates treated with Prostaglandin E1, particularly in those under 2000 g?

• A. Hypertension
• B. Seizures
• C. Tachycardia
• D. Apnea

Answer: (D)

Prostaglandin E1 is used to keep the ductus arteriosus open in certain newborns with congenital heart defects, but it often comes with respiratory side effects. The most common adverse effect in neonates, especially those weighing less than 2000 g, is apnea. This happens because PGE1 can affect the immature respiratory centers and airway control in preterm infants, leading to pauses in breathing or desaturation that may require temporary ventilatory support. The risk is higher in very low birth weight babies due to their immature lungs and central nervous system control.

Hypertension is not the usual concern with PGE1 in this setting, and while tachycardia can occur because of vasodilation and hemodynamic effects, it is not as prominently associated as apnea. Seizures are not a typical adverse effect of PGE1 therapy in neonates. Therefore, apnea stands out as the most common and clinically significant complication to monitor for, particularly in those under 2000 g.