Abstract
The diagnosis of neonatal hypertension(HTN) has been complicated by the limited available normative data and hence, arbitrary assignment of the upper limit of normal blood pressure(BP). Our objective was to determine a normative data base. BPs were recorded every 8 hrs for up to 30 days in 121 preterm and 61 term infants who required an umbilical artery catheter(UAC). Dinamap was used after discontinuation of UAC. Infants were grouped as follows: <1.0 kg (n=17), 1.0-1.5 kg (n=41), 1.5-2.5 kg (n=63) and >2.5 kg (n=61). In each group, mean arterial pressure(MAP) rose steeply over the first 5 days. At all times, BP was higher in infants with the greater birth weight(BW). Predictive equations for MAP as a function of postnatal age(PNA) best fit a curvilinear relationship (MAP=a+b.ln[day]). The following tabulates the MAP(mmHg) and 95% confidence limits for single measurements.
Both PNA and BW markedly influence BP values. By prior definition(MAP >70 × 3 days) 10% of these asymptomatic neonates would be hypertensive. The present criteria reduces the incidence to 2% which is in accordance with our previous report of symptomatic HTN. This dynamic definition of the range of BP with respect to BW and PNA more precisely identifies HTN in sick neonates.
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Stork, E., Carlo, W., Kliegman, R. et al. HYPERTENSION REDEFINED FOR CRITICALLY ILL NEONATES. Pediatr Res 18 (Suppl 4), 321 (1984). https://doi.org/10.1203/00006450-198404001-01368
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DOI: https://doi.org/10.1203/00006450-198404001-01368