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Etiology, clinical features, and diagnosis of neonatal hypertension

Joseph T Flynn, MD, MS
Section Editors
Joseph A Garcia-Prats, MD
Tej K Mattoo, MD, DCH, FRCP
Deputy Editor
Melanie S Kim, MD


Hypertension can be detected in 1 to 2.5 percent of all neonates (both term and preterm infants) admitted to neonatal intensive care units (NICUs). The clinician needs to be knowledgeable about normative blood pressure (BP) values, the optimal method to measure BP in newborns, the underlying etiologies, and clinical manifestations, in order to identify and treat neonatal hypertension.

The definition, etiology, clinical features, and diagnostic evaluation of neonatal hypertension will be reviewed here. Treatment of hypertension in infants is discussed separately. (See "Management of hypertension in infants".)


Hypertension — Neonatal hypertension is defined as persistent systolic and/or diastolic blood pressure (BP) that exceeds the 95th percentile for postmenstrual (sometimes referred to as postconceptional) age (figure 1 and table 1). However, it is challenging to define normal neonatal BP as there is a lack of normative BP in this age group. In addition, there are a number of factors that affect normal BP values during the neonatal period (defined as the first 28 days of life). As a result, it has been difficult to develop a standardized definition of hypertension for clinical use in this age group.

Normal BP — Normal BP in newborns varies with gestational age, postmenstrual age, and birth weight. BP values increase following birth, with greater rates of increase seen in preterm infants compared with term infants.

Useful data on BP in newborns were obtained in a study of 608 newborns admitted to 14 neonatal intensive care units (NICUs) in the Philadelphia area (figure 2 and figure 3) [1]. Systolic BP and diastolic BP were measured by oscillometric device every eight hours for 1 to 99 days after delivery. The following findings were noted:


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Literature review current through: Mar 2017. | This topic last updated: Aug 12, 2015.
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