RESUMO
PURPOSE: Pulmonary hypertension (PH) is known as a major risk factor for preterm infants deaths, and associated with low gestational age, low birth weight, longer duration of oxygen therapy, low Apgar scores, and oligohydramnios. The aim of this study was to determine the risk factors for PH in preterm infants with chronic lung disease. METHODS: A retrospective review was performed of data from 86 infants ( or =G3) and severe chronic lung disease was higher in PH group than control group. According to multivariate analysis, IVH (> or =G3) (OR=5.00, 95% CI=1.10-22.63, P=0.037) and severe BPD (OR=2.43, 95% CI=1.03-15.41, P=0.045) were found to be significant risk factors for PH in preterm infants with chronic lung disease. CONCLUSION: Pulmonary hypertension was significantly increased in preterm infants with chronic lung disease when associated with IVH (> or =G3). We suggest that effort for early diagnosis and management for PH would be helpful in preterm infants with chronic lung disease when severe IVH was combined.
Assuntos
Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Displasia Broncopulmonar , Diagnóstico Precoce , Idade Gestacional , Ventrículos do Coração , Hemorragia , Hospitalização , Concentração de Íons de Hidrogênio , Hipertensão Pulmonar , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Pulmão , Pneumopatias , Análise Multivariada , Oligo-Hidrâmnio , Oxigênio , Respiração Artificial , Estudos Retrospectivos , Fatores de RiscoRESUMO
Hypertension is common medical problem encountered during pregnancy. However medication administered for maternal hypertension may cause fetal or neonatal complications. Angiotensin converting enzyme inhibitor or angiotensin II receptor blocker are rarely used during pregnancy, and there are few reports about the effect of them, because administration of these drugs during pregnancy may cause oligohydramnios, renal tubular dysplasia, hypocalvaria, pulmonary hypoplasia, intrauterine growth retardation, neonatal anuria and persistent ductus arteriosus. We report a case of neonatal acute renal failure by angiotensin II receptor blocker during pregnancy. In this case, the neonate with meconium aspiration was admitted to neonatal intensive care unit (NICU). During the NICU stay, neonatal anuria occurred, and there was a medical history that his mother took Candesartan Cilexeril (Atacand(R)), one of angiotensin II receptor blockers during pregnancy. The neonate showed intrinsic acute renal failure, so fluid was restricted and diuretics were administered to the neonate, and after 10 days, anuria improved.