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

Authors:
Wolfgang Göpel, Mirja Müller, Heike Rabe, Johannes Borgmann, Tanja K Rausch, Kirstin Faust, Angela Kribs, Jörg Dötsch, David Ellinghaus, Christoph Härtel, Claudia Roll, Miklos Szabo, Peter Nürnberg, Andre Franke, Inke R König, Mark A Turner, Egbert Herting
Year of publication:
2019
Volume:
-
Issue:
-
Issn:
1359-2998
Journal title abbreviated:
Arch. Dis. Child. Fetal Neonatal Ed.
Journal title long:
Archives of disease in childhood. Fetal and neonatal edition
Impact factor:
3.861
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.