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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
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Characteristics of hypertension in premature infants with and without chronic lung disease: a long-term multi-center

Randall D Jenkins1, Julia K Aziz2, Ladawna L Gievers3

  • 1Oregon Health & Science University, 707 SW Gaines Rd, Mail Code CDRC-P, Portland, OR, 97239, USA. jenkinra@ohsu.edu.

Pediatric Nephrology (Berlin, Germany)
|July 5, 2017
PubMed

Insights

Unexplained neonatal hypertension in premature infants, often linked to low plasma renin activity (PRA), typically resolves with spironolactone treatment. Chronic lung disease (CLD) did not significantly alter the favorable outcome.

Area of Science:

  • Neonatology
  • Pediatric Nephrology
  • Cardiology

Background:

  • Neonatal hypertension in premature infants can have unknown causes.
  • Investigating unexplained hypertension is crucial for appropriate management.
  • Comparing outcomes in infants with and without chronic lung disease (CLD) provides valuable insights.

Purpose of the Study:

  • To describe cases of unexplained hypertension in premature infants.
  • To compare the characteristics and outcomes of hypertensive premature infants with and without CLD.
  • To identify potential therapeutic strategies for this condition.

Main Methods:

  • A retrospective review of premature infants with hypertension was conducted over 16 years.
  • Inclusion criteria included hypertension at <6 months of age and <37 weeks gestation, excluding known secondary causes.
  • Statistical analyses included analysis of variance for continuous variables and chi-square tests for nominal variables.

Main Results:

  • Of 97 infants, 37 had CLD. Hypertension presented around 11.3 weeks chronological age and 39.6 weeks postmenstrual age.
  • 98% of infants had low plasma renin activity (PRA). Spironolactone was effective in 51 of 56 cases.
  • Infants with CLD had lower birthweight and gestational age but similar postmenstrual age at presentation.

Conclusions:

  • Unexplained hypertension in premature infants, with or without CLD, presents around 40 weeks postmenstrual age.
  • Low PRA, transient course, and positive response to spironolactone are characteristic.
  • This suggests a specific pathophysiological mechanism responsive to spironolactone.
Abstract

Keywords:
Blood pressureChronic lung diseaseHypertensionNeonatalPlasma renin activity

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