A pediatric cardiologist’s view on the causes of arterial hypertension in children born at the time of extremely early premature birth

Throughout their lives, children born at the time of extremely early preterm birth (EPB) deserve special attention, as they have an increased chance of developing heart and vascular diseases, namely arterial hypertension (AH). Therefore, there is a need to draw up a treatment and diagnostic algorithm and develop a plan for dispensary observation and optimal treatment. The study objective was to identify the causes of hypertension in children born at the EPB period. Materials and methods. A total of 96 premature infants were examined. The main group consisted of 60 patients born at the EPB term. Group 1 consisted of patients weighing less than 749 g (n=15). Group 2 consisted of patients weighing more than 752 g (n=45). Group 3 (comparison group) (n=36) consisted of infants born at 32.3-36.4 weeks of gestation. A group of patients at risk of hypertension was identified; the renin-angiotensin system parameters were assessed. Results and discussion. Premature infants had elevated blood pressure (BP) during the second year of life. Arterial hypertension was most frequently recorded in extremely premature infants. In extremely immature infants, renin and angiotensin II levels were high, which clinically manifested as hypertension. Conclusion. This study shows that morpho-functional disorders of the fetus and placenta may be possible causes of hypertension in premature infants. Therefore, the observed children need constant blood pressure measurement, in addition to observation by a pediatric cardiologist according to a personal schedule to establish possible cases of hypertension.