Early Postnatal Blood Pressure and Intraventricular Haemorrhage in Very and Extremely Preterm Neonates: A Matched Case-Control Study
- 1Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Medical University of Graz, Graz, Austria
- 2Research Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, Austria
- 3Research Unit for Optimization of Postnatal Monitoring for Preterm and Term Neonates, Medical University of Graz, Graz, Austria
Abstract
Introduction: Immediate postnatal transition is a vulnerable phase, especially in preterm neonates. Arterial blood pressure (ABP) modulates cerebral perfusion and may contribute to intraventricular haemorrhage (IVH) when autoregulation is impaired. Evidence for its role during transition remains limited. We investigated associations between ABP and IVH.
Methods: We conducted a retrospective matched case-control study at the Medical University of Graz including neonates born <32 weeks’ gestation between 2009 and 2025. Cases with IVH grade ≥II during the first week of life and an oscillometric ABP measurement at 15 min after birth were matched 1:1 to controls without IVH by gestational age (±3 days), birth weight (±70 g), sex, and cord clamping strategy. Systolic, mean, and diastolic ABP (SABP, MABP, DABP) were compared using paired analyses. Subgroup analyses were performed according to infection status and physiological-based cord clamping (PBCC).
Results: Forty-four neonates with IVH grade ≥II (median GA 25 weeks; BW 755 g) were matched to 44 controls. Baseline characteristics were similar. At 15 min after birth, IVH cases had lower SABP, MABP, and DABP (Holm-adjusted p = 0.018, 0.012, 0.018, respectively), consistently below the 10th percentile. Infection occurred only among IVH cases. The association remained consistent across infection-stratified analyses, but no significant difference was detected in the exploratory PBCC subgroup.
Conclusion: Reduced ABP at 15 min after birth is strongly associated with IVH ≥ grade II. Values below the 10th percentile may indicate circulatory compromise. Early ABP assessment may improve risk stratification and monitoring.
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- Blood pressure management in acute intracerebral haemorrhage: a Time–Trajectory–Phenotype framework
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BibTeX
@article{pfurtscheller2026early,
title = {{Early Postnatal Blood Pressure and Intraventricular Haemorrhage in Very and Extremely Preterm Neonates: A Matched Case-Control Study}},
author = {Daniel Pfurtscheller and Carina Tripolt and Nariae Baik-Schneditz and Lukas Peter Mileder and Nina Höller and Melina Winkler and Ena Suppan and Bernhard Schwaberger and Gerhard Pichler},
journal = {Neonatology},
year = {2026},
month = oct,
doi = {10.1159/neo/adsag025},
url = {https://doi.org/10.1159/neo/adsag025},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Early Postnatal Blood Pressure and Intraventricular Haemorrhage in Very and Extremely Preterm Neonates: A Matched Case-Control Study
AU - Daniel Pfurtscheller
AU - Carina Tripolt
AU - Nariae Baik-Schneditz
AU - Lukas Peter Mileder
AU - Nina Höller
AU - Melina Winkler
AU - Ena Suppan
AU - Bernhard Schwaberger
AU - Gerhard Pichler
PY - 2026
DA - 2026/10/09
JO - Neonatology
DO - 10.1159/neo/adsag025
UR - https://doi.org/10.1159/neo/adsag025
AB - Introduction: Immediate postnatal transition is a vulnerable phase, especially in preterm neonates. Arterial blood pressure (ABP) modulates cerebral perfusion and may contribute to intraventricular haemorrhage (IVH) when autoregulation is impaired. Evidence for its role during transition remains limited. We investigated associations between ABP and IVH. Methods: We conducted a retrospective matched case-control study at the Medical University of Graz including neonates born <32 weeks’ gestation between 2009 and 2025. Cases with IVH grade ≥II during the first week of life and an oscillometric ABP measurement at 15 min after birth were matched 1:1 to controls without IVH by gestational age (±3 days), birth weight (±70 g), sex, and cord clamping strategy. Systolic, mean, and diastolic ABP (SABP, MABP, DABP) were compared using paired analyses. Subgroup analyses were performed according to infection status and physiological-based cord clamping (PBCC). Results: Forty-four neonates with IVH grade ≥II (median GA 25 weeks; BW 755 g) were matched to 44 controls. Baseline characteristics were similar. At 15 min after birth, IVH cases had lower SABP, MABP, and DABP (Holm-adjusted p = 0.018, 0.012, 0.018, respectively), consistently below the 10th percentile. Infection occurred only among IVH cases. The association remained consistent across infection-stratified analyses, but no significant difference was detected in the exploratory PBCC subgroup. Conclusion: Reduced ABP at 15 min after birth is strongly associated with IVH ≥ grade II. Values below the 10th percentile may indicate circulatory compromise. Early ABP assessment may improve risk stratification and monitoring.
SN - 1661-7800
SN - 1661-7819
ER -