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Neonatal Med > Volume 18(2); 2011 > Article
Journal of the Korean Society of Neonatology 2011;18(2):211-220.
DOI: https://doi.org/10.5385/jksn.2011.18.2.211    Published online November 25, 2011.
Late-onset Hypotension and Late Circulatory Collapse Due to Adrenal Insufficiency in Preterm Infants with Gestational Age Less than 32 Weeks.
Jin A Lee, Chang Won Choi, Ee kyung Kim, Han suk Kim, Beyong Il Kim, Jung hwan Choi
1Department of Pediatrics, Seoul National University Boramae Hospital, Seoul, Korea.
2Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. kimhans@snu.ac.kr
Late-onset hypotension in preterm infants is not a rare condition. Late circulatory collapse due to adrenal insufficiency (AI) is one of the major causes of late-onset hypotension. We assessed the incidence and causes of late-onset hypotension. We also compared the clinical findings according to the presence of AI.
In total, 244 preterm infants with a gestational age < or =32 weeks and who were admitted to the neonatal intensive care unit (NICU) of Seoul National University Boramae Hospital and Seoul National University Hospital from January 2009 to April 2011 were included. Clinical findings were analyzed retrospectively.
Forty-four infants (18%) suffered from late-onset hypotension. Hydrocortisone was administered to 30 infants (68.2%) and AI occurred in 16 infants (36.4%). Cesarean section, sepsis before hypotension, and gastrointestinal surgery were independently associated with late-onset hypotension. Intrauterine growth retardation (IUGR) was less frequent in the hydrocortisone-treated group than in infants not treated with hydrocortisone. The AI group had fewer IUGR infants, and the duration of hospitalization was shorter in the AI group than in infants who were not administered hydrocortisone. Blood pressure tended to normalize more quickly in the AI group, however, the difference was not significant.
AI was a major cause of late-onset hypotension, and the use of hydrocortisone shortened the length of hospitalization.
Key Words: Late-onset hypotension, Infant, Premature, Adrenal insufficiency


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