Genetic background of high blood pressure is associated with reduced mortality in premature neonates.



Göpel, Wolfgang, Müller, Mirja, Rabe, Heike ORCID: 0000-0002-2047-8875, Borgmann, Johannes, Rausch, Tanja K, Faust, Kirstin, Kribs, Angela, Dötsch, Jörg, Ellinghaus, David, Härtel, Christoph
et al (show 7 more authors) (2020) Genetic background of high blood pressure is associated with reduced mortality in premature neonates. Archives of disease in childhood. Fetal and neonatal edition, 105 (2). 184 - 189.

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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
Uncontrolled Keywords: Humans, Hypertension, Genetic Predisposition to Disease, Risk Factors, Prospective Studies, Gestational Age, Blood Pressure, Genotype, Infant, Infant, Newborn, Infant, Very Low Birth Weight, Infant, Premature, Intensive Care Units, Neonatal, Female, Male, Perinatal Mortality
Depositing User: Symplectic Admin
Date Deposited: 19 Feb 2020 16:24
Last Modified: 08 May 2020 21:03
DOI: 10.1136/archdischild-2019-317131
Open Access URL: https://fn.bmj.com/content/105/2/184.info
URI: http://livrepository.liverpool.ac.uk/id/eprint/3075759