Blood Pressure Outcomes in NICU-Admitted Infants with Neonatal Hypertension: A Pediatric Nephrology Research Consortium Study - 11/12/23

Doi : 10.1016/j.jpeds.2023.113765

Nianzhou Xiao, MD, MS ^1,^⁎ , Michelle Starr, MD, MPH ^2,³, Adrienne Stolfi, PhD ⁴, Gilad Hamdani, MD ⁵, Shireen Hashmat, MD ⁶, Stefan G. Kiessling, MD ⁷, Christina Sethna, MD ⁸, Mahmoud Kallash, MD ⁹, Robyn Matloff, MD ¹⁰, Robert Woroniecki, MD ¹¹, Keia Sanderson, MD ¹², Ikuyo Yamaguchi, MD, PhD ¹³, Stephen D. Cha, MD ¹⁴, Michael G. Semanik, MD ¹⁵, Rahul Chanchlani, MD ¹⁶, Joseph T. Flynn, MD, MS ³, Mark Mitsnefes, MD, MS ¹⁷
¹ Department of Nephrology, Valley Children's Healthcare, Madera, CA
² Riley Hospital for Children and Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
³ Division of Nephrology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, WA
⁴ Department of Pediatrics, Wright State University, Dayton, OH
⁵ Nephrology and Hypertension Institute, Schneider's Children Medical Center, Petah Tikva, Israel
⁶ Department of Pediatrics, University of Chicago, Chicago, IL
⁷ Division of Pediatric Nephrology, Kentucky Children's Hospital, University of Kentucky, Lexington, KY
⁸ Division of Pediatric Nephrology, Cohen Children's Medical Center, Zucker School of Medicine at Hofstra/Northwell, Queens, NY
⁹ Division of Nephrology, Nationwide Children's Hospital, Columbus, OH
¹⁰ Division of Pediatric Nephrology, Connecticut Children's Hospital, University of Connecticut School of Medicine, Hartford, CT
¹¹ Division of Pediatric Nephrology and Hypertension, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY
¹² Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, NC
¹³ Division of Nephrology and Hypertension, Department of Pediatrics, Oklahoma Children's Hospital at University of Oklahoma Health Sciences Center, Oklahoma, OK
¹⁴ Division of Nephrology, Akron Children's Hospital, Akron, OH
¹⁵ Division of Nephrology, Department of Pediatrics, University of Wisconsin at Madison, Madison, WI
¹⁶ Division of Pediatric Nephrology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
¹⁷ Division of Nephrology and Hypertension, Cincinnati Children's Medical Center, Cincinnati, OH

^∗Reprint requests: Nianzhou Xiao, MD, MS, Department of Pediatric Nephrology, Valley Children's Healthcare, 9300 Valley Children's Place, Madera, CA 93636.Department of Pediatric NephrologyValley Children's Healthcare9300 Valley Children's PlaceMaderaCA93636

Abstract

Objective

To describe the blood pressure outcomes of infants admitted to the neonatal intensive care unit (NICU) with idiopathic (nonsecondary) hypertension (HTN) who were discharged on antihypertensive therapy.

Study design

Retrospective, multicenter study of 14 centers within the Pediatric Nephrology Research Consortium. We included all infants with a diagnosis of idiopathic HTN discharged from the NICU on antihypertensive treatment. The primary outcome was time to discontinuation of antihypertensive therapy, grouped into (≤6 months, >6 months to 1 year, and >1 year). Comparisons between groups were made with χ² tests, Fisher's exact tests, and ANOVA.

Results

Data from 118 infants (66% male) were included. Calcium channel blockers were the most prescribed class of antihypertensives (56%) in the cohort. The percentages remaining on antihypertensives after NICU discharge were 60% at 6 months, 26% at 1 year, and 7% at 2 years. Antenatal steroid treatment was associated with decreased likelihood of antihypertensive therapy >1 year after discharge.

Conclusions

This multicenter study reports that most infants admitted to the NICU diagnosed with idiopathic HTN will discontinue antihypertensive treatment by 2 years after NICU discharge. These data provide important insights into the outcome of neonatal HTN, but should be confirmed prospectively.

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Keywords : hypertension, pediatric, neonates, NICU

Abbreviations : ACE, HTN, NICU

Plan

Methods

Study Sample

Definitions and Outcomes

Statistical Analysis

Results

Patient Characteristics

Length of Antihypertensive Therapy after NICU Discharge

Antihypertensive Therapy Prescriptions

Association of Maternal Characteristics with Length of Antihypertensive Therapy

Discussion

	N.X. and M.S. contributed equally.
	Portions of this data were presented as a platform presentation at Pediatric Academic Society Meeting, April 24-May 19, 2019, Baltimore, MD.
	Deidentified individual participant data will be made available to researchers who provide a methodologically sound proposal for use in achieving the goals of the approved proposal.

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Article 113765- janvier 2024 Retour au numéro

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Blood Pressure Outcomes in NICU-Admitted Infants with Neonatal Hypertension: A Pediatric Nephrology Research Consortium Study - 11/12/23

Abstract

Objective

Study design

Results

Conclusions

Plan

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