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The changing spectrum of hypertension in premature infants

Journal of Perinatology volume 39, pages 1528–1534 (2019)Cite this article

Subjects

Abstract

Objective

The objective is to document changes in the etiologic spectrum of hypertension in premature infants.

Study design

We reviewed all cases of systemic hypertension (HTN) in premature infants at two centers over 8 years. Infants were sorted into categorical groups as described in 2012 by Flynn. Analyses included frequency of diagnosis, timecourse of HTN, and diagnostics. Phthalate exposure via intravenous fluid and respiratory equipment was compared among groups and centers.

Results

One hundred and twenty-nine infants having 130 episodes of HTN met the inclusion criteria. Sixty-five percent of cases were classified as pulmonary and 16% as miscellaneous. Plasma renin activity (PRA) was undetectable or <11 ng/mL/h in almost all hypertensive infants. Cases categorized as Pulmonary, medications/intoxications, and miscellaneous presented near 40 weeks postmenstrual age, with low PRA and large phthalate exposures.

Conclusions

High PRA HTN has been replaced by low PRA in most cases, and may be due to phthalate exposure.

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Acknowledgements

The authors acknowledge the assistance of Drs Douglas Leonard, Declan O’Riordan, Scott Snyder, and Robert Schelonka for their support of this research in their neonatal units. The authors also thank Andrew Stout for his editing and proofreading assistance.

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Authors and Affiliations

  1. Oregon Health & Science University, 707 SW Gaines St., Portland, Oregon, USA

    K. Farnbach, S. Iragorri, A. Al-Uzri, D. Rozansky & R. Jenkins

  2. Boise State University, Boise, Idaho, USA

    R. Forbush

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  1. K. Farnbach
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  2. S. Iragorri
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  4. D. Rozansky
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Correspondence to R. Jenkins.

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Farnbach, K., Iragorri, S., Al-Uzri, A. et al. The changing spectrum of hypertension in premature infants. J Perinatol 39, 1528–1534 (2019). https://doi.org/10.1038/s41372-019-0457-z

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