Percentile Charts of Neonatal Blood Pressure Values at a Tertiary Iranian Hospital

N. Khalesi, N. Hooman, M. Kashaki, R. Bayat, Asma Javid, S. Shojaee, A. Safaeiasl, Soheila Mahdavynia
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Abstract

Background: Blood pressure (BP) is an important vital sign and indicator of clinical stability. Therefore, the accurate measurement and interpretation of this physiological signal is essential for the optimal management of ill newborns. In this regard, the present study aimed to determine BP values and percentiles in stable newborns in the first weeks of life and evaluate the relevant factors.Methods: This prospective observational study was conducted on 320 term and preterm newborns between 26 and 42 weeks gestational age (GA) within 2015-2017. The exclusion criteria entailed: 1) birth asphyxia,2) preeclampsia, 3) gestational diabetes mellitus (GDM) type I, 4) illicit substance use, and 5) major congenital anomaly. The oscillometric technique was used for BP measurement and systolic and diastolic BPs were analyzed by regression analysis for various percentiles (5th to 95th).Results: The neonates in the current study consisted of 185 (57.8%) males and 135 (42.2%) females with mean (SD) birth weight of 2058.3±582.5grams. Mean (SD) gestational age was reported as 32.95(3.97) weeks. 69.1 % of neonates were delivered via cesarean section. Percentile charts (5th- 95th values) which were developed for systolic (SBP) and diastolic (DBP) demonstrated a steady rise on the respective days that were comparable between different groups. Term neonates were found to have higher BPs, compared to their preterm counterparts on the respective days. Moreover, the neonates who were delivered vaginally had higher mean BP values than neonates delivered via cesarean section.Conclusion: The current study provided normative BP values among neonates, especially in the first two weeks of life. Data presented in this study which include delivery-mode-specific BP percentile curves using an oscillometric method serve as a valuable reference for physicians in the management of newborns in the neonatal unit.
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伊朗三级医院新生儿血压值百分位数图
背景:血压(BP)是临床稳定性的重要生命体征和指标。因此,准确测量和解释这一生理信号对于新生儿的最佳管理至关重要。在这方面,本研究旨在确定稳定的新生儿在生命最初几周的血压值和百分位数,并评估相关因素。方法:本前瞻性观察研究对2015-2017年期间320例26 ~ 42周胎龄(GA)足月和早产儿进行了研究。排除标准包括:1)出生窒息,2)先兆子痫,3)妊娠期糖尿病(GDM) I型,4)非法药物使用,5)重大先天性异常。采用示波技术测量血压,采用回归分析各百分位数(5 ~ 95)对收缩期和舒张期血压进行分析。结果:本组新生儿男185例(57.8%),女135例(42.2%),平均(SD)出生体重为2058.3±582.5g。平均(SD)胎龄为32.95(3.97)周。剖宫产率为69.1%。收缩压(SBP)和舒张压(DBP)的百分位图(第5 - 95个值)显示在各自的日子里稳步上升,不同组之间具有可比性。研究发现,在相应的日子里,足月新生儿的血压高于早产儿。此外,阴道分娩的新生儿的平均血压值高于剖宫产分娩的新生儿。结论:本研究为新生儿提供了规范的血压值,特别是在生命的前两周。本研究中提出的数据包括使用振荡法的分娩模式特异性血压百分位曲线,为新生儿病房的医生管理新生儿提供了有价值的参考。
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