Göpel, Wolfgang, Müller, Mirja, Rabe, Heike, Borgmann, Johannes, Rausch, Tanja K, Faust, Kirstin, Kribs, Angela, Dötsch, Jörg, Ellinghaus, David, Härtel, Christoph, Roll, Claudia, Szabo, Miklos, Nürnberg, Peter, Franke, Andre, König, Inke R, Turner, Mark A and Herting, Ebgert (2019) Genetic background of high blood pressure is associated with reduced mortality in premature neonates. Archives of Disease in Childhood Fetal and Neonatal Edition. ISSN 1359-2998

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Abstract

Objective The aim of our study was to determine if a genetic background of high blood pressure is a survival factor in preterm infants.

Design Prospective cohort study.

Setting Patients were enrolled in 53 neonatal intensive care units.

Patients Preterm infants with a birth weight below 1500 g.

Exposures Genetic score blood pressure estimates were calculated based on adult data. We compared infants with high genetic blood pressure estimates (>75th percentile of the genetic score) to infants with low genetic blood pressure estimates (<25th percentile of the genetic score).

Main outcome measures Lowest blood pressure on the first day of life and mortality.

Results 5580 preterm infants with a mean gestational age of 28.1±2.2 weeks and a mean birth weight of 1022±299 g were genotyped and analysed. Infants with low genetic blood pressure estimates had significantly lower blood pressure if compared with infants with high genetic blood pressure estimates (27.3±6.2vs 27.9±6.4, p=0.009, t-test). Other risk factors for low blood pressure included low gestational age (−1.26 mm Hg/week) and mechanical ventilation (−2.24 mm Hg, p<0.001 for both variables, linear regression analysis). Mortality was significantly reduced in infants with high genetic blood pressure estimates (28-day mortality: 21/1395, 1.5% vs 44/1395, 3.2%, p=0.005, Fisher’s exact test). This survival advantage was independent of treatment with catecholamines.

Conclusions Our study provides first evidence that a genetic background of high blood pressure may be beneficial with regard to survival of preterm infants.

Item Type:	Article
Keywords:	High Blood Pressure Reduced Mortality Premature Neonates
Schools and Departments:	Brighton and Sussex Medical School > Brighton and Sussex Medical School
Subjects:	R Medicine > RJ Pediatrics > RJ0091 Supposed prenatal influence. Prenatal culture. Stirpiculture
Depositing User:	Angela Blazey
Date Deposited:	20 Aug 2019 08:51
Last Modified:	21 Oct 2019 14:30
URI:	http://sro.sussex.ac.uk/id/eprint/84264

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