Neonatal Hypertension

(1) Background: The incidence of hypertension in very low birthweight (VLBW) infants in a single neonatal intensive care unit (NICU) dropped markedly during a 2-year period when the IV fluid (IVF) in both the antenatal unit and the NICU temporarily changed to a di-2-ethylhexyl phthalate (DEHP)-free formulation. The objective of the current report is to document this observation and demonstrate the changes in incidence of hypertension were not associated with the variation in risk factors for hypertension; (2) Methods: The charts of all VLBW infants born in a single NICU during a 7-year span were reviewed. This time includes 32 months of baseline, 20 months of DEHP-free IVF, 20 months of IVF DEHP re-exposure, and two 4-month washout intervals. The group of interest was limited to VLBW infants with bronchopulmonary dysplasia (BPD). Chi-square analysis was used to compare incidence of hypertension among periods. Vermont Oxford NICU Registry data were examined for variation in maternal and neonatal risk factors for hypertension; Results: Incidence of hypertension in VLBW infants with BPD decreased from 7.7% (baseline) to 1.4% when IVF was DEHP-free, rising back to 10.1% when DEHP-containing IVF returned to use. Risk factors for neonatal hypertension were stable across the 3 study periods in the NICU’s group of VLBW infants; (3) Conclusions: Serendipitous removal of IVF containing DEHP resulted in near elimination of hypertension in one NICU—an effect entirely reversed after the same brand of DEHP-containing IVF returned to clinical use. These results suggest that DEHP exposure from IVF plays a major role in neonatal hypertension.

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Neonatal Hypertension

NeoReviews ◽

10.1542/neo.18-6-e357 ◽

2017 ◽

Vol 18 (6) ◽

pp. e357-e371 ◽

Cited By ~ 2

Author(s):

Kirtida Mistry ◽

Charu Gupta

Keyword(s):

Neonatal Hypertension

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Neonatal hypertension: an educational review

Pediatric Nephrology ◽

10.1007/s00467-018-3996-1 ◽

2018 ◽

Vol 34 (6) ◽

pp. 1009-1018 ◽

Cited By ~ 1

Author(s):

Matthew W. Harer ◽

Alison L. Kent

Keyword(s):

Neonatal Hypertension

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Transient hyperaldosteronism and neonatal hypertension: Case series and literature review

Journal of Clinical Neonatology ◽

10.4103/jcn.jcn_57_18 ◽

2018 ◽

Vol 7 (3) ◽

pp. 185 ◽

Cited By ~ 2

Author(s):

EssaHamdan Al Awad ◽

Kamran Yusuf ◽

AmuchouSingh Soraisham ◽

Halah Obaid ◽

Arun Sundaram ◽

...

Keyword(s):

Literature Review ◽

Case Series ◽

Neonatal Hypertension

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Congenital ductus arteriosus aneurysm: an unusual cause of transient neonatal hypertension

BMJ Case Reports ◽

10.1136/bcr-2014-203853 ◽

2014 ◽

Vol 2014 (may05 1) ◽

pp. bcr2014203853-bcr2014203853 ◽

Cited By ~ 3

Author(s):

S. Murki ◽

S. K. Deshbhatla ◽

D. Sharma ◽

N. Rao ◽

S. Verma

Keyword(s):

Ductus Arteriosus ◽

Neonatal Hypertension ◽

Ductus Arteriosus Aneurysm

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Fifteen-minute consultation: Neonatal hypertension

Archives of Disease in Childhood - Education and Practice ◽

10.1136/archdischild-2020-318871 ◽

2020 ◽

pp. edpract-2020-318871

Author(s):

Yogen Singh ◽

Luke McGeoch ◽

Sajeev Job

Keyword(s):

Blood Pressure ◽

Systematic Approach ◽

Reference Data ◽

Antihypertensive Agents ◽

Invasive Monitoring ◽

Older Children ◽

Neonatal Hypertension ◽

Relative Paucity ◽

Dosing Regimens ◽

Postconceptional Age

Neonatal hypertension is a rare but well recognised condition, especially in newborns needing invasive monitoring in the intensive care unit. Recognition of newborns with hypertension remains challenging because of natural variability in blood pressure with postconceptional age and the lack of reference data for different gestational ages. Investigation of neonates with hypertension can be challenging in light of the myriad differing aetiologies. This may be simplified by a systematic approach to investigation. There remains a relative paucity of data to guide the use of pharmacological therapies for hypertension in neonates. Clinicians rely on empirical management protocols based on experience and expert opinion. Much of the information on dosing regimens and protocols has simply been derived from the use of antihypertensive agents in older children and in adults, despite fundamental pathophysiological differences.

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