Early neonatal hypotension in premature infants born to preeclamptic mothers.
BACKGROUND
Early neonatal hypotension (ENH) is common in premature infants and has been claimed to occur more frequently in infants born to mothers with severe preeclampsia. Previous studies that showed a relationship between maternal preeclampsia and neonatal hypotension did not control for potential confounding factors such as birth weight and maternal treatment with magnesium sulfate (MgSO4).


OBJECTIVE
To determine whether maternal preeclampsia is an independent risk factor for ENH.


METHODS
We conducted a retrospective review of all viable singleton infants with gestational age of 23 to 30 weeks who were admitted to the neonatal intensive care unit over a 2-year period. ENH was defined as the persistence of the mean arterial pressure lower than the gestational age in weeks requiring volume expansion and inotropic support in the first 24 h of life.


RESULTS
One hundred and eighty four infants were enrolled. Seventy-five (41%) infants met the diagnostic criteria for ENH. Maternal preeclampsia, the presence of labor, maternal treatment with MgSO4, Apgar scores, birth weight, gestational age and respiratory distress syndrome were significantly associated with ENH by univariate analysis. Only gestational age and maternal preeclampsia were significantly associated with ENH by multiple logistic regression.


CONCLUSIONS
Gestational age and maternal preeclampsia were independent risk factors for ENH in our population of premature infants.
Teng
R-J
RJ
Department of Pediatrics, Division of Neonatology, University of Florida Health Science Center, Jacksonville, FL 32209, USA. rjteng@hotmail.com
Wu
T-J
TJ
Sharma
R
R
Garrison
R D
RD
Hudak
M L
ML
D001794:Blood Pressure; D005260:Female; D005333:Fetus / Q000098:blood supply; D005865:Gestational Age; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology* / Q000503:physiopathology; D008278:Magnesium Sulfate / Q000627:therapeutic use; D008297:Male; D011225:Pre-Eclampsia / Q000188:drug therapy / Q000503:physiopathology; D011247:Pregnancy; D012307:Risk Factors
D008278:Magnesium Sulfate