The determination of a normal pattern of systolic blood pressure (SBP) gradient between upper limbs (UL) and lower limbs (LL) in neonates is important in the diagnosis of the coarctation syndrome. The scarcity of studies of normal neonates and the conflict of opinion prompted us to evaluate this problem. The UL and LL systolic blood pressures of 100 normal term Chinese neonates were measured by the Doppler Ultrasonic method (Roche Arterio sonde 1020).
Under resting condition, the majority (89%) of our neonates had a negative SBP gradient (LL > UL). The mean LL SBP (70.1 mmHg) was significantly higher than that of the UL (59.5 mmHg), p < 0.001. Eleven out of 100 of our neonates had a positive (UL > LL) SBP gradient. Eight of these were less than 1 week old. None had a positive gradient of more than 20 mmHg. According to the results of our study, during the first week of life, normal neonates may have upper limb pressure greater than lower limb of up to 20 mmHg.
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References
1.
O'Brien ET, O'Malley K.ABC of blood pressure measurement: infancy and childhood. Br Med J1979; 1:1048-9.
2.
De Swiet M, Peto J., Shinebourne EADifference between upper and lower limb blood pressure in normal neonates using Doppler technique. Arch Dis Child1974;49:734-5.
3.
Kirkland RT, Kirkland JLSystolic blood pressure measurement of neonates with the transcutaneous Doppler method. J Pediatr1972:80:52-6.
4.
Gill D., O'Brien NG. Systolic blood pressure in the newborn. J Irish Med Assoc1977;70(14):419-20.
5.
Goldring D., Wohltmann H.Flush method for blood pressure determinations in newborn infants . J Pediatr1952;40:285-9.
6.
Moss AJ, Liebling W., Adams FHThe flush method for determining blood pressures in infants. Pediatrics1958;21:950-7.
7.
Park MK, Guntheroth WGDirect blood pressure measurements in brachial and femoral arteries in children . Circulation1970;12:231-7.
8.
Hartmann AF , Jr., Goldring D., Strauss AW, et al. Coarctation of the aorta. In: Moss AJ, Adams FH, Emmanouilides GC, eds. Heart disease in infants, children and adolescents. 2nd ed. Baltimore: Williams & Wilkins Co., 1977:199-209.
9.
Hochberg HMAccurate non-invasive measurement of blood pressure in neonates, infants and children by ultrasonic techniques. Pediatrics Digest1973;15:33-9.
10.
Hamilton WF , Woodbury RA, Harper HT, Jr. Physiologic relationships between intrathoracic, intraspinal and arterial pressures. JAMA1936 ;107:853.
11.
Kirkendall WM, Burton AC, Epstein FH, et al. Recommendations for human blood pressure determination by sphygmomanometers. Circulation1967;36:980-8.
12.
Guntheroth WG, Nadas ASBlood pressure measurements in infants and children. Pediatr Clin North Am1955;2:257-63.
13.
Evaluation of the heart and circulation in health and disease . In: Nelson WE, ed. Textbook of pediatrics. 11th ed. Philadelphia : WB Saunders, 1979:1252.
14.
Baldwin JS, Doyle EFThe heart and circulation in early life. In: Holt, McIntosh, Barnett, eds. Pediatrics. 13th ed. New York: Appleton-Century-Crofts, 1962:520.
