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Discrepancies in the normative neonatal blood pressure reference ranges
Shwetal P Lalan1, Bradley A Warady
1Division of Pediatric Nephrology, Children's Mercy Hospital, University of Missouri at Kansas City, Kansas City, Missouri, USA.
Blood Pressure Monitoring
|March 11, 2015
Summary
Discrepancies in neonatal blood pressure (BP) reference ranges stem from varied study designs and methodologies. Future research requires standardized multicenter studies to establish reliable neonatal BP norms.
Area of Science:
- Neonatal Medicine
- Clinical Research Methodology
- Pediatric Cardiology
Background:
- Normative blood pressure (BP) reference ranges for neonates show significant variation across published studies.
- This variability presents challenges in diagnosing and managing neonatal BP abnormalities.
Purpose of the Study:
- To identify factors contributing to the wide variation in published neonatal BP reference ranges.
- To propose improved study designs for establishing more accurate neonatal BP normative data.
Main Methods:
- An extensive literature search was conducted on PubMed for studies on neonatal BP reference ranges published between 1965 and 2014.
- Analysis focused on identifying common limitations in existing research.
Main Results:
- Key limitations identified include small sample sizes, inconsistent measurement techniques (oscillometric vs. intra-arterial), and failure to account for crucial factors like postconception age, daily weight changes, and medications.
- Studies often included neonates with broad ranges of gestational age, birth weight, and postconception age, further confounding results.
Conclusions:
- Inconsistencies in neonatal BP reference ranges are primarily attributed to methodological flaws and study design limitations.
- Future multicenter studies must address these identified issues to generate reliable and standardized neonatal BP normative data.
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