Australian National University Medical School, Canberra, ACT, 2601, Australia.
Dept of Pediatrics, Division of Nephrology, University of Alabama, Birmingham, AL, USA.
Pediatr Res. 2018 Aug;84(2):279-289. doi: 10.1038/s41390-018-0018-8. Epub 2018 May 23.
Hypertension occurs in up to 3% of neonates admitted to the Neonatal Intensive Care Unit (NICU), and is a potentially under-recognized condition. The aim of this study was to examine the incidence of documented and undiagnosed hypertension from the 24-center Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) database, and to assess risk factors for hypertension according to gestational age.
Diagnosed hypertension was documented if an infant had a discharge diagnosis of hypertension and/or discharged on antihypertensive medications. Undiagnosed hypertension was defined when infants did not have a diagnosis of hypertension, but >50% of the lowest mean, diastolic and systolic blood pressure recordings were >95 percentile for gestational age.
Of the 2162 neonates enrolled in the study, hypertension was documented in 1.8%. An additional 3.7% were defined as having undiagnosed hypertension. There was a significant correlation with neonatal hypertension and acute kidney injury (AKI). Additional risk factors for neonatal hypertension were hyperbilirubinaemia, Caucasian race, outborn, vaginal delivery, and congenital heart disease. Protective factors were small for gestational age, multiple gestations, and steroids for fetal maturation.
Neonatal hypertension may be an under-recognized condition. AKI and other risk factors predispose infants to hypertension.
高血压在入住新生儿重症监护病房（NICU）的新生儿中发生率高达 3%，是一种潜在的未被识别的疾病。本研究旨在从 24 中心全球新生儿急性肾损伤流行病学评估（AWAKEN）数据库中检查已确诊和未确诊高血压的发生率，并根据胎龄评估高血压的危险因素。
如果婴儿有高血压的出院诊断和/或出院时使用抗高血压药物，则记录为确诊高血压。如果婴儿没有高血压的诊断，但>50%的最低平均舒张压和收缩压记录值>胎龄的第 95 百分位数，则定义为未确诊高血压。
在研究中纳入的 2162 名新生儿中，有 1.8%记录了高血压。另有 3.7%被定义为患有未确诊的高血压。新生儿高血压与急性肾损伤（AKI）有显著相关性。新生儿高血压的其他危险因素包括高胆红素血症、白种人、院外出生、阴道分娩和先天性心脏病。小胎龄、多胎妊娠和胎儿成熟的类固醇是保护因素。
新生儿高血压可能是一种未被识别的疾病。AKI 和其他危险因素使婴儿易患高血压。
