TY - JOUR T1 - Early postnatal hypotension and developmental delay at 24 months of age among extremely low gestational age newborns JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - F321 LP - F328 DO - 10.1136/adc.2010.183335 VL - 96 IS - 5 AU - J Wells Logan AU - T Michael O'Shea AU - Elizabeth N Allred AU - Matthew M Laughon AU - Carl L Bose AU - Olaf Dammann AU - Daniel G Batton AU - Stephen C Engelke AU - Alan Leviton AU - for the ELGAN Study Investigators Y1 - 2011/09/01 UR - http://fn.bmj.com/content/96/5/F321.abstract N2 - Objectives To evaluate in extremely low gestational age newborns, relationships between indicators of hypotension during the first 24 postnatal hours and developmental delay at 24 months of age. Methods The 945 infants in this prospective study were born at <28 weeks, were assessed for three indicators of hypotension in the first 24 postnatal hours, and were evaluated with the Bayley Mental Development Index (MDI) and Psychomotor Development Index (PDI) at 24 months corrected age. Indicators of hypotension included: (1) mean arterial pressure in the lowest quartile for gestational age; (2) treatment with a vasopressor; and (3) blood pressure lability, defined as the upper quartile for the difference between the lowest and highest mean arterial pressure. Logistic regression was used to evaluate relationships between hypotension and developmental outcomes, adjusting for potential confounders. Results 78% of infants in this cohort received volume expansion or vasopressor; all who received a vasopressor were treated with volume expansion. 26% had an MDI <70 and 32% had a PDI <70. Low MDI and PDI were associated with low gestational age, which in turn, was associated with receipt of vasopressor treatment. Blood pressure in the lowest quartile for gestational age was associated with vasopressor treatment and labile blood pressure. After adjusting for potential confounders, none of the indicators of hypotension were associated with MDI <70 or PDI <70. Conclusions In this large cohort of extremely low gestational age newborns, we found little evidence that early postnatal hypotension indicators are associated with developmental delay at 24 months corrected gestational age. ER -