Neonatal systemic hypertension across the PHIS database: An update*

Background: The definition of systemic hypertension in the neonatal population remains elusive given the variability of normative blood pressure measurements. Inadequate literature exists about incidence, therapy and long-term management of systemic hypertension in neonates. We aimed to describe the current incidence of neonatal systemic hypertension, differences in demographic and risk factors data.Methods: Retrospective cohort of neonates (<= 28 days) admitted to a neonatal intensive care unit participating in Pediatric Health Information System (PHIS) between Jan 2010 and December 2020 with an ICD 9/10 code for hypertension. Patients were excluded if they had congenital heart disease lesions that might contribute to systemic hypertension or had incomplete data.Results: There were a total of 2494 hypertensive patients among the 432,367 NICU patients meeting the study inclusion criteria, with an incidence of 0.6%. Patients with hypertension were significantly more likely to die before discharge compared to patients without HTN (8.4% versus 3.8%, respectively, p < 0.001). Of the 2494, 52.8% received at least one antihypertensive agent, with hydralazine being the most prescribed agent (29.7%).Conclusion: Diagnosis of Systemic hypertension continues to increase in the neonatal population, despite absence of well-defined criteria necessitating targeted medical management. A consensus guideline which addresses this very important condition is beneficial.

Automated summary

This study aimed to describe the incidence, demographic and risk factors, and therapy of systemic hypertension in neonates. The retrospective analysis found an incidence of 0.6% and a higher mortality rate among hypertensive patients. The majority of hypertensive neonates received antihypertensive medications, with hydralazine being the most prescribed agent.