Hypotension in Preterm Neonates: Low Blood Pressure Alone Does Not Affect Neurodevelopmental Outcome

Objective To compare neurodevelopmental outcome, mean arterial blood pressure (MABP), and regional cerebral oxygenation (rSco 2 ) between preterm neonates treated for hypotension and controls. Study design Preterm neonates (N = 66) with a gestational age (GA) ≤32 weeks, without a patent ductus arteriosus, treated for hypotension (dopamine ≥5 μg/kg/min) were included. Neonates were matched to controls for GA, birth weight, sex, and year of birth. The rSco 2 was determined by using near-infrared spectroscopy. Monitoring of MABP, rSco 2 , and arterial saturation was started at admission and continued for at least 72 hours. Neurodevelopmental outcome was assessed at 18 and 24 months' corrected age by using the Griffiths Mental Development Scales or the Bayley Scales of Infant and Toddler Development, Third Edition. Results Infants treated for hypotension spent more time with an MABP less than GA (median 9% vs 0%, P 2 correlation >0.5 (27% vs 17%, P 2 2 10% of time had a lower neurodevelopmental outcome at 18 months (median 99 vs 104, P  = .02). Conclusion An MABP less than GA (in weeks) was not associated with lower rSco 2 or with lower neurodevelopmental outcome scores. However, regardless of MABP, low rSco 2 was associated with lower neurodevelopmental outcome scores. Perfusion/oxygenation variables could be of additional value in neonatal intensive care.