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Antihypertensive drug exposure in premature infants from 1997 to 2013

Srikanth Ravisankar1, Devon Kuehn1, Reese H Clark2

  • 11Department of Pediatrics,East Carolina University,Greenville,North Carolina,United States of America.

Cardiology in the Young
|October 18, 2016
PubMed

Insights

Systemic hypertension affects premature infants, with limited treatment evidence. This study found wide variations in antihypertensive drug use among these vulnerable infants, highlighting a need for standardized treatment protocols.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Pharmacology

Background:

  • Systemic hypertension is increasingly recognized in premature infants.
  • Current treatment recommendations for neonatal hypertension are largely based on expert opinion due to limited evidence.
  • This study addresses the gap in understanding antihypertensive drug use in this population.

Purpose of the Study:

  • To describe the current use of antihypertensive drugs in premature infants born at or before 32 weeks of gestation.
  • To analyze the characteristics of premature infants requiring antihypertensive therapy.
  • To identify variations in treatment practices for neonatal hypertension.

Main Methods:

  • Retrospective cohort study of infants born ≤32 weeks gestation and ≤1500 g birth weight.
  • Data collected from 348 neonatal ICUs between 1997 and 2013.
  • Comparison of characteristics between treated and untreated infants using statistical tests (Wilcoxon's ranked sum test, Pearson's χ2-test).

Main Results:

  • 2.1% of eligible infants (2504/119,360) received antihypertensive drugs.
  • Hydralazine was the most common drug (51.1%).
  • Infants receiving antihypertensives were of lower gestational age and birth weight (p<0.001).

Conclusions:

  • This is the largest study detailing antihypertensive drug exposure in premature infants (≤32 weeks gestation).
  • Significant variations in treatment practices for hypertension in premature infants were observed.
  • Findings underscore the need for evidence-based guidelines for managing neonatal hypertension.
Abstract

Keywords:
Pharmacotherapyhypertensionneonateprematurityvery low birth weight

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