Pfurtscheller Daniel, Schlatzer Christoph, Höller Nina, Schwaberger Bernhard, Mileder Lukas P, Baik-Schneditz Nariae, Pichler Gerhard
Research Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, Graz, 8036, Austria.
Ital J Pediatr. 2025 May 21;51(1):149. doi: 10.1186/s13052-025-02001-y.
The transition from intrauterine to extrauterine life presents challenges for neonates, who are at increased risk of cardio-respiratory instability. Although electrocardiogram monitoring is recommended for neonatal resuscitation after birth, its ability to assess cardiovascular function is limited. Measuring arterial blood pressure (ABP) is feasible in neonates during the immediate transition period, though its interpretation is complex. This study analyses ABP values during the immediate transition in preterm neonates.
Data from neonates born at the Medical University of Graz between 2009 and 2023 were analysed. All preterm neonates who survived without intraventricular haemorrhage grade II or higher, and who had ABP measured non-invasively at 15 min after birth, were eligible for inclusion. Statistical analyses were employed to evaluate ABP values for each gestational week, ranging from 23 to 36 weeks of gestation.
Out of 305 eligible neonates, 267 preterm neonates met the inclusion criteria. The median (IQR) systolic ABP ranged from 46 (43-51) to 64 (56-68) mmHg showing a gradual increase with advancing gestational age. The mean ABP ranged from 30 (27-36) to 45 (37-47) mmHg, also exhibiting a gradual increase with higher gestational age. Similarly, the diastolic ABP ranged from 22 (19-29) to 34 (29-41) mmHg, again showing a gradual increase with advancing gestational age.
The findings indicate that ABP values during the immediate transition may be higher than those described after immediate transition in large cohort studies. Moreover, the gradual increase in ABP in preterm neonates with advancing gestational age underscores the necessity for tailored approaches to neonatal cardiovascular management during immediate transition.
从宫内生活过渡到宫外生活对新生儿来说是一项挑战，他们发生心肺功能不稳定的风险增加。尽管出生后新生儿复苏推荐进行心电图监测，但其评估心血管功能的能力有限。在新生儿即刻过渡期测量动脉血压（ABP）是可行的，不过其解读较为复杂。本研究分析了早产儿即刻过渡期的ABP值。
分析了2009年至2023年在格拉茨医科大学出生的新生儿数据。所有存活且无二级或更高级别脑室内出血、出生后15分钟进行无创ABP测量的早产儿均符合纳入标准。采用统计分析评估妊娠23至36周各孕周的ABP值。
在305例符合条件的新生儿中，267例早产儿符合纳入标准。收缩压ABP的中位数（四分位间距）范围为46（43 - 51）至64（56 - 68）mmHg，随孕周增加呈逐渐上升趋势。平均ABP范围为30（27 - 36）至45（37 - 47）mmHg，也随孕周增加而逐渐上升。同样，舒张压ABP范围为22（19 - 29）至34（29 - 41）mmHg，同样随孕周增加而逐渐上升。
研究结果表明，即刻过渡期的ABP值可能高于大型队列研究中即刻过渡期后所描述的值。此外，随着孕周增加，早产儿ABP逐渐升高，这凸显了在即刻过渡期对新生儿心血管管理采取个性化方法的必要性。
