Maternal pre-eclampsia as a risk factor for developing bronchopulmonary dysplasia in neonates

The aim of this study was to determine the effect of pre-eclampsia on the development of bronchopulmonary dysplasia (BPD) in preterm infants.

Retrospective cohort study of infants' ≤32 weeks' gestation admitted to a level-IV single center neonatal intensive care unit from 2014 to 2016. Infants with major congenital anomalies, death or transfer before 28 days were excluded. Infants were stratified by maternal pre-eclampsia status. Demographic, clinical, and laboratory data were reviewed. Logistic regression was used to examine predictors for BPD. Main Outcome measure: The primary outcome was BPD incidence.

Four hundred thirty-two infants met inclusion criteria; 22% developed BPD, of which, 16% had severe BPD. Thirty-eight percent of infants were born to preeclamptic mothers, with 23% of those infants developing BPD. Infants born to preeclamptic mothers were delivered by cesarean section (88% vs. 60%; P<0.0001) more often and had lower birthweight (median = 1265g, IQR 910-1555 vs. median = 1388g, IQR 959-1752; P=0.008) compared to infants born to non-preeclamptic mothers. Higher incidence of intrauterine growth restriction was noted in pre-eclampsia group, 24% vs. 8%, P=0.0001). Gestational age, length of stay and days on ventilator were all associated with the development of BPD. In multivariable logistic regression, pre-eclampsia was not a risk factor for development of BPD (OR 1.12 [0.68, 1.83]).

Pre-eclampsia was not a significant risk factor for development of BPD nor the severity of BPD in infants' ≤32 weeks' gestation. IUGR infants with or without pre-eclampsia mothers were at higher risk for BPD.