The hypertensive neonate

Semin Fetal Neonatal Med. 2020 Oct;25(5):101138. doi: 10.1016/j.siny.2020.101138. Epub 2020 Jul 12.

Abstract

Hypertension in neonates is increasingly recognized because of improvements in neonatal intensive care that have led to improved survival of premature infants. Although normative data on neonatal blood pressure remain limited, several factors appear to be important in determining blood pressure levels in neonates, especially gestational age, birth weight and maternal factors. Incidence is around 1% in most studies and identification depends on careful blood pressure measurement. Common causes of neonatal hypertension include umbilical catheter associated thrombosis, renal parenchymal disease, and chronic lung disease, and can usually be identified with careful diagnostic evaluation. Given limited data on long-term outcomes and use of antihypertensive medications in these infants, clinical expertise may need to be relied upon to decide the best approach to treatment. This review will discuss these concepts and identify evidence gaps that should be addressed.

Keywords: Blood pressure; Chronic lung disease; Hypertension; Kidney disease; Neonate; Prematurity.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Blood Pressure / physiology
  • Female
  • Gestational Age
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / drug therapy
  • Hypertension / etiology
  • Hypertension / therapy*
  • Infant, Newborn
  • Infant, Newborn, Diseases / diagnosis*
  • Infant, Newborn, Diseases / drug therapy
  • Infant, Newborn, Diseases / etiology
  • Infant, Newborn, Diseases / therapy*
  • Infant, Premature / physiology*
  • Intensive Care Units, Neonatal
  • Renal Artery Obstruction / complications

Substances

  • Antihypertensive Agents