Pichler Gerhard, Cheung Po-Yin, Binder Corinna, O'Reilly Megan, Schwaberger Bernhard, Aziz Khalid, Urlesberger Berndt, Schmölzer Georg M
Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; Department of Pediatrics, University of Alberta, Edmonton, Canada; Division of Neonatology, Department of Pediatrics, Medical University, Graz, Austria.
Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; Department of Pediatrics, University of Alberta, Edmonton, Canada.
PLoS One. 2014 Dec 16;9(12):e114504. doi: 10.1371/journal.pone.0114504. eCollection 2014.
To describe temporal changes in systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP, respectively) in term and preterm infants immediately after birth.
Prospective 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.
Term 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.
We 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.
描述足月儿和早产儿出生后即刻收缩压、舒张压和平均血压（分别为SBP、DBP和MBP）的时间变化。
前瞻性观察性双中心研究。对足月儿在出生后的前15分钟每分钟进行无创性SBP、DBP和MBP评估，对早产儿在出生后的前15分钟每分钟进行评估，以及在出生后20、25、30、45和60分钟进行评估。对所有新生儿按性别和呼吸支持进行回归分析；对早产儿按分娩方式、脐带夹闭时间和超声检测到的脑损伤情况进行回归分析。
足月儿（n = 54）的平均（标准差）出生体重为3298（442）g，胎龄为38（1）周，早产儿（n = 94）体重为1340（672）g，胎龄为30（3）周。足月儿出生后前15分钟内的SBP、DBP和MBP与性别或呼吸支持无关。线性混合回归分析显示，出生时为女性、经阴道分娩、脐带夹闭延迟、不需要正压通气且未发生脑室周围损伤或脑室扩大的早产儿，在出生后第一小时内的某些测量点，其SBP、DBP和MBP显著更高。
我们给出了一组足月儿和早产儿出生后即刻血压的新参考范围。它们可能有助于在所有孕周的早期过渡期间优化心血管支持。
