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早产史是否会促使在初级保健就诊时进行血压评估?

Does History of Prematurity Prompt Blood Pressure Evaluations at Primary Care Visits?

作者信息

Kornfeld Benjamin D, Finer Gal, Banks Laura E, Bolanos Liliana, Ariza Adolfo J

机构信息

Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.

Northwestern University, Chicago, IL, USA.

出版信息

Glob Pediatr Health. 2019 Jan 31;6:2333794X19828314. doi: 10.1177/2333794X19828314. eCollection 2019.

Abstract

Prematurity is a risk factor for elevated blood pressure (BP). We performed a mixed-methods study of care patterns and awareness of early BP screening recommendations for infants born prematurely (IBP) by interviewing/surveying providers on practice- and provider-level BP screening. IBP's records were reviewed for BP screening documentation, demographics, and gestational age (GA). Visits <33 months were reviewed for anthropometrics, BP, and comorbidities. Chi-square analysis evaluated BP screening by GA and comorbidities. Twenty-six of 49 practices completed interviews; 81% had infant BP equipment available; 4% had BP measurement protocol for IBP. Twenty-eight of 86 providers were aware of screening guidelines; none reported routine assessment. Twenty-eight of 118 IBP had ≥1 BP documented; 43% had BP ≥90th percentile. Screening did not differ by GA group. Kidney-related diagnosis was associated with more frequent BP screening ( = .0454). BP is not routinely measured though often elevated before age 3 in IBP.

摘要

早产是血压升高的一个风险因素。我们通过就实践层面和医疗服务提供者层面的血压筛查对医疗服务提供者进行访谈/调查,对早产儿(IBP)的护理模式以及对早期血压筛查建议的认知情况开展了一项混合方法研究。查阅了IBP的记录,以获取血压筛查文件、人口统计学信息和胎龄(GA)。对33个月以下的就诊情况进行了人体测量学、血压和合并症方面的审查。卡方分析按GA和合并症评估血压筛查情况。49家医疗机构中有26家完成了访谈;81%配备了婴儿血压测量设备;4%有针对IBP的血压测量方案。86名医疗服务提供者中有28名知晓筛查指南;无人报告进行常规评估。118名IBP中有28名有≥1次记录的血压值;43%的血压值≥第90百分位数。筛查在不同GA组之间无差异。与肾脏相关的诊断与更频繁的血压筛查相关(P = 0.0454)。尽管IBP在3岁前血压常升高,但未进行常规测量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5912/6360474/ea0dd1891ae5/10.1177_2333794X19828314-fig1.jpg

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