Blood Pressure Normative Values in Preterm Infants During Postnatal Transition

Overview

Journal Pediatr Res

Specialties Biology
Pediatrics

Date 2023 Sep 4

PMID 37667035

Authors

Yasser Elsayed

Faraz Ahmed

Affiliations

Soon will be listed here.

Abstract

Background: The normative blood pressure values in preterm infants still not well defined during postnatal transition. We aimed to create normative blood pressure (BP) reference values in preterm infants <29 weeks gestational age recorded hourly during the postnatal transition.

Methods: We included only data from hemodynamically stable newborns. Only BP values measured by umbilical arterial catheter (UAC) were included. The regression model showed that only gestational age and postnatal age in hours determine the BP.

Results: We included 206 out of 547 admitted preterm infants. The BP increases with increasing gestational ages and overtime during the postnatal transition. We constructed 5 BP centile values for each gestational group. BP histograms show that the BP most of the time fluctuated between the 5th and 75th centile values, particularity during day one of life.

Conclusions: The BP trend values gradually increase in stable preterm infants during the postnatal transition, and preterm infants who do not follow this trend might require hemodynamics assessment.

Impact: The normative blood pressure is increasing gradually during the first 3 days after birth and is different with gestational ages. This is first normative blood pressure centile values in stable preterm infant and based on invasive blood pressure monitoring. The data enable more accurate monitoring of hemodynamics in preterm infants during postnatal transition.

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References

Stebor A . Basic principles of noninvasive blood pressure measurement in infants. Adv Neonatal Care. 2005; 5(5):252-61. DOI: 10.1016/j.adnc.2005.06.005. View

Lurbe E, Torro I, Rodriguez C, Alvarez V, Redon J . Birth weight influences blood pressure values and variability in children and adolescents. Hypertension. 2001; 38(3):389-93. DOI: 10.1161/01.hyp.38.3.389. View

Evans N, Iyer P . Change in blood pressure after treatment of patent ductus arteriosus with indomethacin. Arch Dis Child. 1993; 68(5 Spec No):584-7. PMC: 1029308. DOI: 10.1136/adc.68.5_spec_no.584. View

Doyle L, Faber B, Callanan C, Morley R . Blood pressure in late adolescence and very low birth weight. Pediatrics. 2003; 111(2):252-7. DOI: 10.1542/peds.111.2.252. View

Kent A, Chaudhari T . Determinants of neonatal blood pressure. Curr Hypertens Rep. 2013; 15(5):426-32. DOI: 10.1007/s11906-013-0375-y. View

Weber F, Koning L, Scoones G . Defining hypotension in anesthetized infants by individual awake blood pressure values: a prospective observational study. Paediatr Anaesth. 2017; 27(4):377-384. DOI: 10.1111/pan.13091. View

Modanlou H, Yeh S, Siassi B, Hon E . Direct monitoring of arterial blood pressure in depressed and normal newborn infants during the first hour of life. J Pediatr. 1974; 85(4):553-9. DOI: 10.1016/s0022-3476(74)80469-5. View

Alderliesten T, Lemmers P, van Haastert I, de Vries L, Bonestroo H, Baerts W . Hypotension in preterm neonates: low blood pressure alone does not affect neurodevelopmental outcome. J Pediatr. 2014; 164(5):986-91. DOI: 10.1016/j.jpeds.2013.12.042. View

Fisher D, Heymann M, Rudolph A . Regional myocardial blood flow and oxygen delivery in fetal, newborn, and adult sheep. Am J Physiol. 1982; 243(5):H729-31. DOI: 10.1152/ajpheart.1982.243.5.H729. View

10.

Batton B, Li L, Newman N, Das A, Watterberg K, Yoder B . Evolving blood pressure dynamics for extremely preterm infants. J Perinatol. 2014; 34(4):301-5. PMC: 3982788. DOI: 10.1038/jp.2014.6. View

11.

Cayabyab R, McLean C, Seri I . Definition of hypotension and assessment of hemodynamics in the preterm neonate. J Perinatol. 2009; 29 Suppl 2:S58-62. DOI: 10.1038/jp.2009.29. View

12.

Pereira S, Sinha A, Morris J, Wertheim D, Shah D, Kempley S . Blood pressure intervention levels in preterm infants: pilot randomised trial. Arch Dis Child Fetal Neonatal Ed. 2018; 104(3):F298-F305. DOI: 10.1136/archdischild-2017-314159. View

13.

Banerjee J, Leung T, Aladangady N . Cerebral blood flow and oximetry response to blood transfusion in relation to chronological age in preterm infants. Early Hum Dev. 2015; 97:1-8. DOI: 10.1016/j.earlhumdev.2015.10.017. View

14.

Fanaroff J, Fanaroff A . Blood pressure disorders in the neonate: hypotension and hypertension. Semin Fetal Neonatal Med. 2006; 11(3):174-81. DOI: 10.1016/j.siny.2006.01.002. View

15.

Nelson R, Stebor A, Groh C, Timoney P, Theobald K, Friedman B . Determination of accuracy in neonates for non-invasive blood pressure device using an improved algorithm. Blood Press Monit. 2002; 7(2):123-9. DOI: 10.1097/00126097-200204000-00006. View

16.

Batton B . Neonatal Blood Pressure Standards: What Is "Normal"?. Clin Perinatol. 2020; 47(3):469-485. DOI: 10.1016/j.clp.2020.05.008. View

17.

Elsayed Y, Abdul Wahab M . A new physiologic-based integrated algorithm in the management of neonatal hemodynamic instability. Eur J Pediatr. 2021; 181(3):1277-1291. DOI: 10.1007/s00431-021-04307-5. View

18.

Amer R, Moddemann D, Seshia M, Alvaro R, Synnes A, Lee K . Neurodevelopmental Outcomes of Infants Born at <29 Weeks of Gestation Admitted to Canadian Neonatal Intensive Care Units Based on Location of Birth. J Pediatr. 2018; 196:31-37.e1. DOI: 10.1016/j.jpeds.2017.11.038. View

19.

Eliason S, Whyte H, Dow K, Cronin C, Lee S . Variations in transport outcomes of outborn infants among Canadian neonatal intensive care units. Am J Perinatol. 2012; 30(5):377-82. DOI: 10.1055/s-0032-1324706. View

20.

Meyer S, Sander J, Graber S, Gottschling S, Gortner L . Agreement of invasive versus non-invasive blood pressure in preterm neonates is not dependent on birth weight or gestational age. J Paediatr Child Health. 2010; 46(5):249-54. DOI: 10.1111/j.1440-1754.2009.01679.x. View