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Upper- vs lower-limb systolic blood pressure in full-term normal newborns
Insights
In newborns under 24 hours old, systolic blood pressure (BP) can be higher in either the upper or lower limbs. This initial difference in BP is not linked to birth weight in healthy neonates.
Area of Science:
- Neonatal physiology
- Pediatric cardiology
- Vascular health in infants
Background:
- Assessing blood pressure (BP) in newborns is crucial for monitoring cardiovascular health.
- Understanding limb-specific BP variations in neonates is important for accurate clinical assessment.
- Previous research has not fully characterized upper versus lower limb systolic BP differences in early infancy.
Purpose of the Study:
- To investigate the differences between upper-limb and lower-limb systolic blood pressure (BP) in healthy newborns within the first 24 hours of life.
- To determine if birth weight correlates with these systolic BP measurements in neonates.
- To observe longitudinal changes in limb BP differences up to three years of age.
Main Methods:
- Utilized the oscillometric method for BP measurement in 100 full-term newborns younger than 24 hours.
- Recorded systolic blood pressure (BP) in both upper and lower limbs.
- Conducted follow-up BP evaluations in a subset of 25 infants up to age 3.
Main Results:
- Mean systolic BP in upper limbs was 72.3 +/- 7.6 mm Hg; in lower limbs, it was 71.3 +/- 8.2 mm Hg.
- In 66% of newborns, upper-limb systolic BP was higher than lower-limb BP (mean difference: 3.5 +/- 3.1 mm Hg).
- In 28% of newborns, lower-limb systolic BP was higher (mean difference: 5.1 +/- 5.1 mm Hg); no correlation with birth weight was found. Follow-up showed higher lower-limb BP in 24/25 infants by age 3.
Conclusions:
- It is considered normal for systolic blood pressure (BP) to be higher in either the upper or lower limb in newborns under 24 hours old.
- Systolic BP in newborns younger than 24 hours does not correlate with birth weight.
- Longitudinal data suggests a trend towards higher lower-limb BP in early childhood development.
Abstract:
The difference between upper- vs lower-limb systolic blood pressure (BP) was investigated in 100 normal full-term newborns younger than 24 hours of age by the oscillometric method. The mean systolic BP of both upper limbs was 72.3 +/- 7.6 mm Hg (mean +/- SD). The mean +/- SD systolic BP of both lower limbs was 71.3 +/- 8.2 mm Hg. Systolic BP in the upper limb was greater than that in the lower limb in 66% of newborns by as much as 20 mm Hg (mean +/- SD, 3.5 +/- 3.1). Systolic upper-limb BP was lower than systolic lower-limb BP in 28% of newborns by as much as 21 mm Hg (mean +/- SD, 5.1 +/- 5.1). Systolic BP did not correlate with birth weight. Follow-up evaluation of BP in 25 of the infants up to 3 years of age revealed higher systolic BP in the lower extremities in 24 of the 25 infants. We conclude that (1) it is normal to have a higher systolic BP in either the upper limb or the lower limb in newborns younger than 24 hours of age, and (2) there is no correlation of systolic BP with birth weight in full-term normal neonates younger than 24 hours of age.