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Association between maternal hypertension and infant neurodevelopment in extremely preterm infants
Wael A Abdelmageed1, Anie Lapointe2, Richard Brown3
1Department of Medicine, Division of Experimental Medicine, McGill University Health Center, Montreal, QC, Canada.
Insights
Maternal hypertension in pregnancy increases the risk of neurodevelopmental impairment (NDI) in extremely preterm infants. This risk is significantly higher when combined with small-for-gestational-age (SGA) status.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Obstetrics
Background:
- Extremely preterm infants face high risks of neurodevelopmental impairment (NDI).
- Maternal health conditions during pregnancy can impact infant neurodevelopmental outcomes.
- The specific impact of maternal hypertension on NDI in this vulnerable population requires further investigation.
Purpose of the Study:
- To investigate the association between maternal hypertension during pregnancy and NDI in extremely preterm infants.
- To assess the combined effect of maternal hypertension and small-for-gestational-age (SGA) status on NDI.
- To determine the risk of NDI at 24 months post-menstrual age in relation to these maternal and infant factors.
Main Methods:
- Retrospective cohort study utilizing data from two tertiary neonatal units (2011-2017).
- Inclusion criteria: infants born between 23 weeks 0 days and 28 weeks 6 days gestation.
- Analysis focused on neurodevelopmental impairment (NDI) outcomes in relation to maternal hypertension and small-for-gestational-age (SGA) status.
Main Results:
- Of 1019 infants, 647 had complete data; 15% were exposed to maternal hypertension.
- Maternal hypertension was associated with increased odds of any NDI (aOR: 2.29) and significant NDI (aOR: 2.01).
- The combination of maternal hypertension and SGA significantly elevated the risk for any NDI (aOR: 4.88) and significant NDI (aOR: 6.91).
Conclusions:
- Maternal hypertension during pregnancy is a significant risk factor for neurodevelopmental impairment in extremely preterm infants.
- The presence of both maternal hypertension and small-for-gestational-age (SGA) status substantially increases the risk of NDI.
- These findings highlight the importance of monitoring maternal hypertension and its potential impact on preterm infant neurodevelopment.
Objective:
To examine the association between maternal hypertension during pregnancy and neurodevelopmental impairment (NDI) at 24 months post-menstrual age in extremely preterm infants.
Study Design:
Using data from two tertiary neonatal units (2011-2017) for infants born at 23 + 0 to 28 + 6 weeks, we investigated outcomes of NDI related to maternal hypertension and small-for-gestational-age (SGA) status.
Results:
Of 1019 pre-term infants, 647 had complete data and were included in the analysis. Ninety-six (15%) had maternal hypertension exposure; 25 (4%) were also SGA. Infants with maternal hypertension showed a higher odds of any NDI (aOR: 2.29, 95% CI = 1.36-3.87) and significant NDI (aOR: 2.01, 95% CI = 1.02-3.95). The combination of hypertension and SGA further elevated this risk (aOR for any NDI: 4.88, 95% CI = 1.80-13.22; significant NDI: 6.91, 95% CI = 2.50-19.12).
Conclusion:
Maternal hypertension during pregnancy elevates the risk of NDI in extremely preterm infants, more so when combined with SGA.
