Hypertension in pregnancy and the infant. A controlled follow-up study

A one-year population comprising 119 infants of 113 mothers with hypertension in pregnancy has been studied regarding fetal and neonatal mortality and morbidity. The overall incidence of hypertension in pregnancy was 3.7%, but was higher in preterm deliveries (from 16.6% in gestational weeks 25-29 to 8.6% in gestational weeks 34-36). Fetal loss with intra-uterine death was related to hypertension in pregnancy in 23%. Auxological parameters in 16 SGA infants of hypertensive parturients showed growth recovery in all infants as regards head circumference and in all but 2 as regards body weight and body length. A controlled follow-up study was performed in 104 infants of hypertensive mothers and 104 control infants of similar gestational age and birthweight but without pregnancy complications. There was a significantly higher rate of cesarean section, of low Apgar score at 1 minute, and SGA infants and neonatal morbidity requiring admittance to the neonatal intensive care unit. At 2 years of age the rate of neurodevelopmental handicaps was similar in the study population and in control infants. Stillborn infants all belonged to the group of mothers with hypertension starting before the 21st gestational week and with an increased serum urate level. Three of 4 infants with a handicap at 2 years also belonged to this group of mothers. With modern peri-and neonatal intensive care and appropriate fetal assessment, delivery after 26-28 weeks of gestation seems to be associated with a slightly increased neonatal morbidity but no increase in long-term handicaps at 2 years of age.