Our Summary

This research paper is about a study that looked at the occurrence of high blood pressure in newborn babies with a birth defect called congenital diaphragmatic hernia (CDH), which is a hole in the diaphragm. The researchers analyzed the medical data of 167 babies with CDH who had surgery to fix the hole and lived for at least 60 days. They compared the babies’ blood pressure values to the standard values for their sex, age, and height. High blood pressure was defined as values reaching or above the 95th percentile.

They found that 11.3% of the babies had high blood pressure when they left the hospital, and 63% of these babies were not taking high blood pressure medication. Almost half of the babies (47.9%) were given high blood pressure medication at some point during their hospital stay and 28.9% of them were still taking this medication when they were discharged.

Babies treated with ECMO (a type of life support machine) had higher blood pressure compared to those who did not receive ECMO, but the occurrence of high blood pressure was similar in both groups.

The researchers also found that babies with CDH who were fed with formula and had low levels of creatinine (a waste product that is removed by the kidneys) in the first week of life were more likely to have high blood pressure. However, after further analysis, only low levels of creatinine remained significantly associated with high blood pressure.

The researchers concluded that there is a moderately high occurrence of high blood pressure in babies with CDH when they leave the hospital. They suggest that doctors should be aware of this risk and regularly check the blood pressure and kidney function of these babies.

FAQs

  1. What percentage of babies with CDH had high blood pressure when they left the hospital after surgery?
  2. What factors were found to be associated with high blood pressure in babies with CDH?
  3. What was the significance of the researchers’ findings in relation to babies with CDH and high blood pressure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about congenital diaphragmatic hernia repair is to monitor their baby’s blood pressure regularly, especially if they have had surgery to fix the hole in the diaphragm. It is important to be aware of the risk of high blood pressure in babies with CDH and to work closely with healthcare providers to manage and monitor any potential issues. Additionally, maintaining proper kidney function is important for overall health and can help reduce the risk of high blood pressure in these babies.

Suitable For

Typically, babies with congenital diaphragmatic hernia (CDH) who undergo surgery to repair the hole in the diaphragm are recommended for treatment. In this study, the researchers specifically looked at newborn babies with CDH who survived for at least 60 days after surgery. These babies were found to have a moderately high occurrence of high blood pressure, with 11.3% of them having high blood pressure when they left the hospital.

It is important for doctors to be aware of the risk of high blood pressure in babies with CDH and to monitor their blood pressure and kidney function regularly. Babies who are fed with formula and have low levels of creatinine in the first week of life may be at a higher risk for developing high blood pressure. Therefore, these factors should be taken into consideration when recommending treatment for CDH patients.

Timeline

Before congenital diaphragmatic hernia repair:

  • The baby is diagnosed with congenital diaphragmatic hernia, typically through prenatal ultrasound or shortly after birth
  • The baby may experience respiratory distress, feeding difficulties, and other symptoms related to the hernia
  • The baby undergoes surgery to repair the hole in the diaphragm

After congenital diaphragmatic hernia repair:

  • The baby may experience high blood pressure, as found in the study mentioned above
  • Some babies may require medication to manage their high blood pressure
  • Doctors monitor the baby’s blood pressure and kidney function regularly
  • The baby continues to recover and grow, with ongoing follow-up care to monitor for any long-term effects of the hernia and surgery.

What to Ask Your Doctor

  1. What are the potential long-term effects of high blood pressure in babies with congenital diaphragmatic hernia?
  2. What are the possible causes of high blood pressure in babies with CDH?
  3. How often should my baby’s blood pressure be monitored after surgery for CDH?
  4. Are there any specific lifestyle changes or dietary recommendations to help manage high blood pressure in babies with CDH?
  5. What are the risks and benefits of starting high blood pressure medication in a newborn baby?
  6. Are there any specific factors that increase the risk of high blood pressure in babies with CDH, such as feeding method or kidney function?
  7. Should my baby be seen by a specialist, such as a pediatric nephrologist, for monitoring and treatment of high blood pressure?
  8. What are the potential complications associated with high blood pressure in babies with CDH?
  9. How does the use of ECMO affect the occurrence of high blood pressure in babies with CDH?
  10. Are there any specific warning signs or symptoms of high blood pressure that I should watch out for in my baby with CDH?

Reference

Authors: Engel C, Leyens J, Bo B, Hale L, Lagos Kalhoff H, Lemloh L, Mueller A, Kipfmueller F. Journal: Eur J Pediatr. 2024 Jul;183(7):2831-2842. doi: 10.1007/s00431-024-05509-3. Epub 2024 Apr 6. PMID: 38581464