Risk factors and pulmonary complications in preterm newborns with very low birth weight and extremely low birth weight

Abstract

Introduction. There is no standard definition for neonatal hypotension. In clinical trials it is defined as any value less than the 5th or the 10th percentile for gestational age. In our study, neonatal hypotension is considered to have a mean BP lower than gestational age, which causes hemodynamic disorders and requires treatment. Aim of study. Neonatal hypotension occurs in approximately 25% of children with VLBW. Gestational age and birth weight are high risk factors for neonatal hypotension. Methods and materials. In order to assess how it influence the neonatal hypotension and what are the main complications in newborns with VLBW who developed neonatal hypotension, we performed a retrospective study on a group of 125 newborns less than 32 gestational weeks, born at IMSP IMsC, admitted to neonatal intensive unit, for period 2019-2021. Children with congenital anomalies were not included in the study. Subjects were divided into 2 groups - with and without neonatal hypotension. Results. As a result of the study, we determined that the measures of neonatal resuscitation / medication used, symptomatic patent ductus arteriosus, early neonatal sepsis and chorioamnionitis are closely correlated with the presence of hypotension in the newborn. Also, in children with hypotension, different degrees of IVH were detected, especially III and IV in the subgroup of newborns with VLBW. Mortality rate was quite high (65%), and most survivors developed BPD. Conclusion. Neonatal hypotension is a multifactorial condition, with a high risk of death and disability. It is inversely proportional to the term of gestation and birth weight and is very closely correlated with intrauterine infection, especially early onset sepsis and chorioamnionitis.