PT  - JOURNAL ARTICLE
AU  - Beau Batton
AU  - Lei Li
AU  - Nancy S Newman
AU  - Abhik Das
AU  - Kristi L Watterberg
AU  - Bradley A Yoder
AU  - Roger G Faix
AU  - Matthew M Laughon
AU  - Barbara J Stoll
AU  - Rosemary D Higgins
AU  - Michele C Walsh
TI  - Early blood pressure, antihypotensive therapy and outcomes at 18–22 months’ corrected age in extremely preterm infants
AID  - 10.1136/archdischild-2015-308899
DP  - 2016 May 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - F201--F206
VI  - 101
IP  - 3
4099  - http://fn.bmj.com/content/101/3/F201.short
4100  - http://fn.bmj.com/content/101/3/F201.full
SO  - Arch Dis Child Fetal Neonatal Ed2016 May 01; 101
AB  - Objective To investigate the relationships between early blood pressure (BP) changes, receipt of antihypotensive therapy and 18–22 months’ corrected age (CA) outcomes for extremely preterm infants.Design Prospective observational study of infants 230/7–266/7 weeks’ gestational age (GA). Hourly BP values and antihypotensive therapy exposure in the first 24 h were recorded. Four groups were defined: infants who did or did not receive antihypotensive therapy in whom BP did or did not rise at the expected rate (defined as an increase in the mean arterial BP of ≥5 mm Hg/day). Random-intercept logistic modelling controlling for centre clustering, GA and illness severity was used to investigate the relationship between BP, antihypotensive therapies and infant outcomes.Setting Sixteen academic centres of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.Main outcome measures Death or neurodevelopmental impairment/developmental delay (NIDD) at 18–22 months’ CA.Results Of 367 infants, 203 (55%) received an antihypotensive therapy, 272 (74%) survived to discharge and 331 (90%) had a known outcome at 18–22 months’ CA. With logistic regression, there was an increased risk of death/NIDD with antihypotensive therapy versus no treatment (OR 1.836, 95% CI 1.092 to 3.086), but not NIDD alone (OR 1.53, 95% CI 0.708 to 3.307).Conclusions Independent of early BP changes, antihypotensive therapy exposure was associated with an increased risk of death/NIDD at 18–22 months’ CA when controlling for risk factors known to affect survival and neurodevelopment.Clinical trial registration number clinicaltrials.gov #NCT00874393.