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Northern Neonatal Nursing
Iniative
Correspondence to: Dr W Tin, Department of Paediatrics, South Cleveland Hospital, Middlesbrough TS4 3BW
Accepted 7 August 1998
AIM
To define the normal range of systolic blood
pressure in a non-selective population based sample of babies of low
gestation throughout early infancy.
METHODS
Daily measurements of systolic blood
pressure were made in all the babies of less than 32 weeks gestation
born in the North of England in 1990 and 1991 during the first 10 days
of life. Additional measurements were obtained from 135 of these babies throughout the first year of life. Systolic pressure was measured by
sensing arterial flow with a Doppler ultrasound probe. It was assumed
that blood pressure had never been pathologically abnormal in the
neonatal period if the child was alive and free from severe disability
two years later. Data of adequate quality were available from 398 such
children. Additional data were collected, for comparative purposes,
from 123 babies of 32, 36, or 40 weeks of gestation.
RESULTS
Systolic pressure correlated with weight
and gestation at birth, and rose progressively during the first 10 days
of life. The coefficient of variation did not vary with gestational or postnatal age (mean value 17%), the relation with gestation being closer than with birthweight. Systolic pressure rose 20% during the
first 10 days from an initial mean of 42 mm Hg in babies of 24 weeks
gestation, and by 42% from an initial mean of 48 mm Hg in babies of 31 weeks gestation. These findings were not altered by the exclusion of
data from 14 babies who had inotropic support during this time.
Simultaneous measurements in three centres using an oscillometric
technique revealed that this technique tended to overestimate systolic
pressure when this was below average. Systolic pressure finally
stabilised at a mean of 92 (95% CI 72-112) mm Hg at a postconceptional
age of 44-48 weeks irrespective of gestation at birth.
CONCLUSION
Systolic blood pressure 4-24 hours
after birth was less than gestational age (in weeks) in only 3% of
non-disabled long term survivors. Systolic pressure rose with
increasing gestation and increasing postnatal age, but stabilised some
six weeks after term, regardless of gestation at birth.
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