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Neonatal blood pressure levels of preterm infants who did and did not develop chronic lung disease
1Department of Child Health, King's College Hospital, London, UK.
Insights
Neonatal infants who develop chronic lung disease (CLD) may have slightly higher blood pressure (BP). Prolonged umbilical catheter use is linked to this early BP elevation in premature infants.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Respiratory Medicine
Background:
- Chronic lung disease (CLD) is a significant concern in premature infants.
- Early identification of factors influencing neonatal outcomes is crucial.
- Blood pressure (BP) monitoring in neonates is essential for assessing cardiovascular health.
Purpose of the Study:
- To investigate differences in blood pressure (BP) levels between neonatal infants who develop CLD and those who do not.
- To identify potential factors influencing BP in this population.
Main Methods:
- A cohort of 40 neonatal infants were studied throughout the neonatal period.
- Infants were divided into two groups: those who developed CLD (n=20) and those who did not (n=20).
- Systolic BP was measured non-invasively using Doppler technique on day one and weekly thereafter. Umbilical catheter duration and medication use were recorded.
Main Results:
- Infants who developed CLD had higher BP levels (mean difference of 5 mmHg) compared to the non-CLD group after day one, adjusted for birthweight.
- Prolonged umbilical arterial catheterization (median 8 days vs. 1 day) was significantly more common in the CLD group.
- No significant differences were observed in the use of theophylline or pancuronium between groups.
Conclusions:
- Neonatal infants who develop CLD may exhibit a modest elevation in BP during the neonatal period.
- This early BP elevation appears associated with prolonged umbilical arterial catheterization.
- Significant hypertension in infants who develop CLD is more likely to manifest after the neonatal period.
Abstract:
The aim of this study was to assess if, in the neonatal period, there were differences in the blood pressure (BP) level of infants who did and did not develop chronic lung disease. If such differences were demonstrated to exist, we also hoped to determine influencing factors. Forty infants, consecutively admitted to our unit and who remained there throughout the neonatal period were studied. Twenty infants, median gestational age 29 weeks (range 27-32), did not develop CLD (non-CLD group) and 20 infants, median gestational age 26 weeks (range 24-32), developed CLD. Systolic BP was assessed using a non-invasive Doppler technique on day one and subsequently at weekly intervals. After day one and throughout the neonatal period BP levels, corrected for birthweight, were higher in the CLD group compared to the non-CLD group, by a mean of 5 mmHg. There was no significant difference between the numbers of infants in each group receiving theophylline or pancuronium. Significantly more infants in the CLD group had an umbilical catheter inserted and their catheters remained in situ significantly longer, a median of 8 days compared to a median of one day in the non-CLD group. We conclude that even in the neonatal period infants who develop CLD may have a modest elevation of BP, this is associated with prolonged umbilical arterial catheterisation. Our results, however, suggest that significant hypertension in infants who develop CLD, occurs after the neonatal period.