title: Do maternal- or pregnancy-associated disease states affect blood pressure in the early neonatal period?
abstract: BACKGROUND
  Placental vascular changes associated with maternal disease states may affect fetal vascular development. There is evidence suggesting that being born prematurely is associated with a higher blood pressure (BP) in later life.
  
  
  OBJECTIVE
  To determine whether maternal disease state affects BP in the early neonatal period.
  
  
  METHODS
  Cohort study of neonates admitted to neonatal intensive care unit with exposure to maternal hypertension and diabetes. Inclusion criteria were neonates greater than 27 weeks gestation not ventilated or requiring inotropes for more than 24 h, materna l hypertension (pregnancy induced or essential) or diabetes of any kind requiring treatment, and spontaneous delivery. Exclusion criteria included chromosomal or congenital anomaly and illicit maternal drug use. Oscillometric BP measurements taken until discharge on days 1, 2, 3, 4, 7, 14, 21 and 28. Placental histopathology was performed.
  
  
  RESULTS
  One hundred and ninety infants enrolled, 104 in the control and 86 in the study group. Sixty-five infants were born between 28-31 weeks and 125 infants between 32-41 weeks gestation. Those born between 28-31 weeks with a history of diabetes had a statistically higher systolic, mean and diastolic BP throughout the first 28 days of life (P = 0.001; P = 0.007; P = 0.02). Those born between 32-41 weeks gestation with placental pathology associated with altered uteroplacental perfusion had a higher systolic BP (P = 0.005).
  
  
  CONCLUSIONS
  Maternal- or pregnancy-associated disease states appear to influence BP in the early neonatal period. Diabetes and altered placental perfusion were associated with higher BP readings. Clinical significance of these statistically elevated BPs in the early neonatal period is unknown.
authors.affiliation: Department of Neonatology, Canberra Hospital, Australia. alison.kent@act.gov.au
authors.forename: Alison L
authors.initials: AL
authors.lastname: Kent
authors.forename: Bruce
authors.initials: B
authors.lastname: Shadbolt
authors.forename: Eric
authors.initials: E
authors.lastname: Hu
authors.forename: Sandra
authors.initials: S
authors.lastname: Meskell
authors.forename: Michael C
authors.initials: MC
authors.lastname: Falk
authors.forename: Jane E
authors.initials: JE
authors.lastname: Dahlstrom
mesh_terms: D000704:Analysis of Variance; D001794:Blood Pressure / Q000502:physiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D007363:Intensive Care Units, Neonatal; D010920:Placenta / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D012307:Risk Factors