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OBJECTIVE: To examine changes in arterial blood pressure (ABP) after birth in extremely preterm infants.

STUDY DESIGN: Prospective observational study of infants 230/7 to 266/7 weeks gestational age (GA). Antihypotensive therapy use and ABP measurements were recorded for the first 24 h.

RESULT: A cohort of 367 infants had 18 709 ABP measurements recorded. ABP decreased for the first 3 h, reached a nadir at 4 to 5 h and then increased at an average rate of 0.2 mm Hg h-1. The rise in ABP from hour 4 to 24 was similar for untreated infants (n = 164) and infants given any antihypotensive therapy (n = 203), a fluid bolus (n = 135) or dopamine (n = 92). GA-specific trends were similar. ABP tended to be lower as GA decreased, but varied widely at each GA.

CONCLUSION: ABP increased spontaneously over the first 24 postnatal hours for extremely preterm infants. The rate of rise in ABP did not change with antihypotensive therapy.

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