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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
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Neonatal systemic hypertension across the PHIS database: An update.
Ahmed AlMaazmi1, Joseph Hagan1, Caraciolo J Fernandes1
1Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States of America.
International Journal of Cardiology
|January 22, 2023
Summary
Neonatal systemic hypertension incidence is 0.6%, with hypertensive infants facing higher mortality. Hydralazine is the most common treatment, highlighting the need for clear diagnostic and management guidelines for this growing concern.
Area of Science:
- Neonatology
- Pediatric Cardiology
- Clinical Pediatrics
Background:
- Systemic hypertension definition in neonates is unclear due to variable blood pressure norms.
- Limited data exists on neonatal hypertension incidence, treatment, and long-term outcomes.
- Neonatal hypertension diagnosis is increasing, yet lacks standardized criteria and management protocols.
Purpose of the Study:
- To determine the incidence of systemic hypertension in neonates.
- To analyze demographic and risk factors associated with neonatal hypertension.
- To describe current therapeutic approaches for neonatal hypertension.
Main Methods:
- Retrospective cohort study of neonates (≤28 days) admitted to NICUs.
- Data sourced from the Pediatric Health Information System (PHIS) from 2010-2020.
- Inclusion criteria: ICD 9/10 codes for hypertension; exclusion: congenital heart disease or incomplete data.
Main Results:
- An incidence of 0.6% (2494/432,367) neonatal hypertension was observed.
- Hypertensive neonates had significantly higher mortality before discharge (8.4% vs. 3.8%, p < 0.001).
- 52.8% of hypertensive neonates received antihypertensive agents, most commonly hydralazine (29.7% of treated).
Conclusions:
- Systemic hypertension is increasingly diagnosed in neonates, underscoring the need for defined criteria.
- Targeted medical management is essential for neonatal hypertension.
- Development of consensus guidelines for neonatal hypertension is highly beneficial.
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