Authors: Abdul Mannan, Faria Yasmin, Mosammad Alpana Jahan, Sarbari Saha, Mahbubur Rahman KM, Afrina Wahab.
Background: Blood pressure values of too low or too high can be related with serious morbidity and mortality. Neonatal hypotension has been found to be related with serious short term as well as significant long-term health complications. Thus, identifying this low blood pressure in preterm neonates with its impacts on neonatal health is crucial.
Objectives: To evaluate blood pressure values in preterm newborn and short-term impacts of hypotension on neonatal health.
Methods: This prospective observational study was conducted in Neonatal Intensive Care Unit (NICU) of Bangabandhu Sheikh Mujib Medical University a tertiary care hospital of Dhaka city after approval from Institutional Review Board for a period of one years. Neonates having gestation< 37 completed weeks admitted in NICU of BSMMU were enrolled in the study after getting informed consent from the parents. Proper antenatal and postnatal history were recorded in data collection form. Blood pressure was measured by non-invasive oscillometric method in all neonates within 24 hours after birth by ideal procedure. Blood pressure was monitored at an interval of 12 hours or more frequently when required till discharge or death. Information on neonatal mortality and morbidity were recorded in data collection form.
Results: A total of 114 preterm neonates were studied during the study period, among them 61 (53.5%) had normal blood pressure and 53 (46.5%) had hypotension. Among the enrolled patients, 15 (13.2%) patients died, 3 (2.6%) left against medical advice, 11 (9.6%) 96 (84.2%) were discharged with advice. Short time outcomes like culture proven sepsis, use of ionotrops, need for oxygen support and assisted ventilation, feeding intolerance, Necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity and duration of hospital stay were significantly higher in hypotensive group. Mortality was also higher in hypotensive group than normotensive group (26.4% vs 3.3%, p <0.001).
Conclusion: Hypotension in preterm neonates was associated with significant mortality and morbidity in early post-natal period.