Document Detail


Treated hypotension is associated with neonatal morbidity and hearing loss in extremely low birth weight infants.
MedLine Citation:
PMID:  16585307     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Neonatal hypotension may be a risk factor for neurologic impairment. Few studies have examined the impact of low blood pressure in extremely low birth weight (ELBW) infants weighing 400 to 999 g on neurodevelopmental outcome. OBJECTIVES: We set out to explore the relationship between treated hypotension in the first 72 hours of life and perinatal factors, morbidity, and mortality in ELBW infants and then to compare neurosensory outcome in ELBW infants with treated hypotension and those who never received treatment for hypotension. DESIGN/METHODS: We performed chart review of all 156 ELBW infants admitted to our level III NICU in 1998-1999. Infants had "treated hypotension" if they received fluid pushes, corticosteroids, and/or vasopressors during the first 72 hours of life in an attempt to increase blood pressure. Follow-up included neurologic examination, Bayley Scales of Infant Development, vision and hearing evaluation. Statistical analysis was performed by using SPSS 11.0. Univariate and multivariate analyses were conducted to determine morbidities associated with treated hypotension. RESULTS: Fifty-nine infants received treatment for hypotension. Ninety-seven infants did not. The groups had similar race, gender, delivery mode, chorioamnionitis, and maternal socioeconomic status. Thirty-eight (24%) infants expired, including 20 who received treatment for hypotension. Of the 156 infants in the study group, 110 underwent neurodevelopment testing, and 103 were able to undergo complete neurodevelopment testing and Bayley examination. Multivariate analysis controlling for socioeconomic status and neonatal morbidity revealed that treated hypotension is associated with delayed motor development and hearing loss. CONCLUSIONS: Treated hypotension in ELBW infants in the first 72 hours of life is associated with significant short-term and long-term morbidity. Infants with treated hypotension are more likely to have delayed motor development, hearing loss, and death.
Authors:
Jonathan M Fanaroff; Deanne E Wilson-Costello; Nancy S Newman; Michelle M Montpetite; Avroy A Fanaroff
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  117     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-04     Completed Date:  2006-05-10     Revised Date:  2007-01-30    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1131-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio, USA. jonathan.fanaroff@case.edu
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure
Cerebral Hemorrhage / complications
Cerebral Palsy / complications
Child Development
Evoked Potentials, Auditory, Brain Stem
Hearing Loss / complications*,  diagnosis
Humans
Hypotension / complications*,  physiopathology,  therapy*
Infant, Newborn
Infant, Premature, Diseases / therapy*
Infant, Very Low Birth Weight
Neonatal Screening
Neurologic Examination
Otoacoustic Emissions, Spontaneous
Comments/Corrections
Comment In:
Pediatrics. 2007 Jan;119(1):220-1   [PMID:  17200295 ]

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