Low blood pressure among very-low-birth-weight infants with fetal vessel inflammation

Abstract

Objective: To test the hypothesis that fetal vessel inflammation (FVI: funisitis and/or fetal vasculitis) is associated with lower blood pressure (BP) over the first week of life and an increased risk of periventricular leukomalacia (PVL) among premature infants. Study Design: A total of 255 infants born at <1350 g to normotensive mothers were stratified by gestational age (GA) and grouped by presence/absence of FVI on placental pathology. Daily highest (Hi) and lowest (Lo) systolic BP (BPsys), mean BP (BPmn) and diastolic BP (BPdia) over first 7 days of life were analyzed by repeated measures ANOVA and regression analysis. Cranial ultrasounds were obtained at 2 weeks of life. Results: Infants ≥30 weeks gestation with FVI had lower HiBPsys, HiBPmn, HiBPdia, LoBPsys, LoBPmn and LoBPdia (p<0.001 than did infants without FVI. Infants with PVL (all ≤27 weeks gestation) had lower LoBPmn and LoBPdia (p<0.01 than controls. FVI did not increase the risk of PVL in these infants. Conclusion: FVI and PVL are associated with reduced BP over the first week of life. © 2004 Nature Publishing Group All rights reserved.