OBJECTIVE: To investigate the relationships between early blood pressure (BP) changes, receipt of antihypotensive therapy and 18-22 months' corrected age (CA) outcomes for extremely preterm infants. DESIGN: Prospective observational study of infants 230/7-266/7 weeks' gestational age (GA). Hourly BP values and antihypotensive therapy exposure in the first 24 h were recorded. Four groups were defined: infants who did or did not receive antihypotensive therapy in whom BP did or did not rise at the expected rate (defined as an increase in the mean arterial BP of >/=5 mm Hg/day). Random-intercept logistic modelling controlling for centre clustering, GA and illness severity was used to investigate the relationship between BP, antihypotensive therapies and infant outcomes. SETTING: Sixteen academic centres of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. MAIN OUTCOME MEASURES: Death or neurodevelopmental impairment/developmental delay (NIDD) at 18-22 months' CA. RESULTS: Of 367 infants, 203 (55%) received an antihypotensive therapy, 272 (74%) survived to discharge and 331 (90%) had a known outcome at 18-22 months' CA. With logistic regression, there was an increased risk of death/NIDD with antihypotensive therapy versus no treatment (OR 1.836, 95% CI 1.092 to 3.086), but not NIDD alone (OR 1.53, 95% CI 0.708 to 3.307). CONCLUSIONS: Independent of early BP changes, antihypotensive therapy exposure was associated with an increased risk of death/NIDD at 18-22 months' CA when controlling for risk factors known to affect survival and neurodevelopment. CLINICAL TRIAL REGISTRATION NUMBER: clinicaltrials.gov #NCT00874393
Early blood pressure, antihypotensive therapy and outcomes at 18-22 months' corrected age in extremely preterm infants
Batton, B., Li, L., Newman, NS., Das, A., Watterberg, KL., Yoder, BA., Faix, RG., Laughon, MM., Stoll, BJ., Higgins, RD., & Walsh, MC. (2016). Early blood pressure, antihypotensive therapy and outcomes at 18-22 months' corrected age in extremely preterm infants. Archives of Disease in Childhood - Fetal and Neonatal Edition, 101(3), F201-F206. https://doi.org/10.1136/archdischild-2015-308899
To contact an RTI author, request a report, or for additional information about publications by our experts, send us your request.
Multifaceted risk for non-suicidal self-injury only versus suicide attempt in a population-based cohort of adults
Pregnancy rates and clinical outcomes among women living with HIV enrolled in HPTN 052
The influence of mediators on the relationship between antenatal opioid agonist exposure and the severity of neonatal opioid withdrawal syndrome