Original Article

Journal of Perinatology (2006) 26, 471–475. doi:10.1038/sj.jp.7211558; published online 15 June 2006

Early neonatal hypotension in premature infants born to preeclamptic mothers

Premature infants born to preeclamptic mothers are more prone to develop hypotension requiring inotropes in the first day of life.
Part of the study was presented in the 2004 SPR meeting.

R-J Teng1, T-J Wu1, R Sharma1, R D Garrison1 and M L Hudak1

1Department of Pediatrics, Division of Neonatology, University of Florida Health Science Center, Jacksonville, FL, USA

Correspondence: Dr R-J Teng, Department of Pediatrics, Division of Neonatology, University of Florida, Health Science Center at Jacksonville, 655 West 8th Street, Jacksonville, FL 32209, USA. E-mail: rjteng@hotmail.com

Received 6 January 2006; Revised 18 May 2006; Accepted 24 May 2006; Published online 15 June 2006.

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Abstract

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.

Study Design:

 

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.

Conclusion:

 

Gestational age and maternal preeclampsia were independent risk factors for ENH in our population of premature infants.

Keywords:

hypotension, premature infant, preeclampsia, magnesium sulfate, inotrope

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