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Outcomes of singleton small for gestational age preterm infants exposed to maternal hypertension: a retrospective

Elhaytham ElSayed1, Sibasis Daspal2, Wendy Yee1

  • 1Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Pediatric Research
|May 16, 2019
PubMed

Insights

Infants born small for gestational age (SGA) to mothers with hypertensive disorders of pregnancy (HDP) had lower mortality and bronchopulmonary dysplasia (BPD) rates. These findings suggest a potentially protective effect of HDP in preterm SGA infants.

Area of Science:

  • Neonatal research
  • Perinatal medicine
  • Public health

Background:

  • Hypertensive disorders of pregnancy (HDP) are a significant cause of infants born small for gestational age (SGA).
  • Preterm SGA infants face higher risks of adverse outcomes, but their specific outcomes in the context of HDP are not well understood.
  • Understanding these outcomes is crucial for optimizing neonatal care.

Purpose of the Study:

  • To investigate the outcomes of preterm SGA infants born to mothers with HDP.
  • To compare mortality and major morbidities in preterm SGA infants exposed to HDP versus those not exposed.

Main Methods:

  • A retrospective population-based study utilized the Canadian Neonatal Network database (2010-2016).
  • Included were SGA infants born <33 weeks gestation.
  • Multivariable models assessed adjusted odds ratios (AORs) for mortality and key morbidities, comparing infants of HDP mothers to non-HDP mothers.

Main Results:

  • Of 2081 eligible SGA infants, 1317 (63%) were born to HDP mothers.
  • Infants of HDP mothers showed significantly lower odds of mortality (AOR 0.57, 95% CI 0.39-0.83) and bronchopulmonary dysplasia (BPD) (AOR 0.69, 95% CI 0.53-0.90).
  • Subgroup analyses revealed decreased mortality in infants born at 26-28 and 29-32 weeks gestation, decreased BPD in the 29-32 weeks group, and decreased patent ductus arteriosus (PDA) in the <26 weeks group.

Conclusions:

  • Preterm SGA infants born to mothers with HDP experienced lower odds of mortality and BPD compared to their counterparts born to non-HDP mothers.
  • These findings highlight a potentially protective role of HDP in certain adverse outcomes for preterm SGA infants.
  • Further research may elucidate the mechanisms underlying these observations and inform clinical management.
Abstract

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