Time Course Study of Blood Pressure in Term and Preterm Infants Immediately after Birth

Abstract

ObjectiveTo describe temporal changes in systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP, respectively) in term and preterm infants immediately after birth.MethodsProspective observational two-center study. In term infants SBP, DBP, and MBP were assessed non-invasively every minute for the first 15 minutes, and in preterm infants every minute for the first 15 minutes, as well as at 20, 25, 30, 45, and 60 minutes after birth. Regression analyses were performed by gender and respiratory support in all neonates; and by mode of delivery, cord clamping time, and development of ultrasound-detected brain injury in preterm neonates.ResultsTerm infants (n = 54) had a mean (SD) birth weight of 3298 (442) g and gestational age of 38 (1) weeks, and preterm infants (n = 94) weighed 1340 (672) g and were 30 (3) weeks gestation. Term infants’ SBP, DBP and MBP within the first 15 minutes after birth were independent of gender or respiratory support. Linear mixed regression analysis showed that preterm infants, who were female, born vaginally, had delayed cord clamping and did not require positive pressure ventilation nor develop periventricular injury or ventriculomegaly, had significantly higher SBP, DBP, and MBP at some measurement points within the first hour after birth.ConclusionsWe present novel reference ranges of BP immediately after birth in a cohort of term and preterm neonates. They may aid in optimization of cardiovascular support during early transition at all gestations.

Cerebral haemorrhage in preterm neonates: does cerebral regional oxygen saturation during the immediate transition matter?

“…Another haemodynamic parameter with a potential information value is the blood pressure. Recently reference ranges during the immediate transition have been established in neonates without any need of respiratory support 32. We measured in our present study the blood pressure with the oscillometric method at the 15th minute, but there was no significant difference between the IVH and Non-IVH groups.…”

Pediatric Renal Ontogeny and Applications in Drug Development

“…The low‐resistance blood flow to the placenta ceases at birth, and significant hemodynamic changes convert the fetus from fetal to neonatal circulation. Pulmonary vascular resistance drops, resulting in increased perfusion to the lungs; systemic vascular resistance increases; and within minutes to hours, the ductal shunt reverses, and the ductus arteriosus closes within 48 to 72 hours in a term infant …”

“…Pulmonary vascular resistance drops, resulting in increased perfusion to the lungs; systemic vascular resistance increases; and within minutes to hours, the ductal shunt reverses, and the ductus arteriosus closes within 48 to 72 hours in a term infant. 11 Over the first 2 weeks of life, the most dramatic change in renal function is characterized by a rapid increase in renal blood flow and a rise in GFR. At the same time, urinary sodium output drops, and then sodium participates in new tissue formation.…”

Admission Systolic Blood Pressure and Outcomes in Preterm Infants of ≤ 26 Weeks' Gestation

“…29,30 It is possible that data derived entirely from intra-arterial catheters could give a different result, but fewer very preterm infants are now monitored invasively, and clinical care often relies on noninvasive results. 31 Third, it is possible that few neonates may have received fluid bolus or epinephrine as part of resuscitation, which may have influenced the results somewhat, although the number of such neonates was very small ($4%). Moreover, none of the patients received inotropes before first measurement.…”