Health, Physical Growth, and Neurodevelopmental Outcomes in Preterm Infants of Women With Hypertensive Disorders of Pregnancy

Abstract

Objective: To compare the health, physical growth, and developmental outcomes in preterm infants of women with and without hypertensive disorders of pregnancy (HDP). Design: Cross-sectional analysis of health outcomes; physical growth (head circumference, height, and weight) collected at birth and 2 months corrected for prematurity; and cognitive, language, and motor skills of preterm infants of women with and without HDP. Setting: Four NICUs in the United States. Participants: Women (n=221) and their preterm infants who weighed less than 1750g were enrolled in a multicenter, randomized trial of two interventions administered by the infant’s mother when the infants were no longer critically ill. Methods: Women and their preterm infants were categorized into groups with (n=80) and without (control, n=141) HDP. Data were extracted from infant medical records, and the women completed questionnaires. Results: The infants of women with HDP were more likely to be small for gestational age than the infants of women without HDP (31.7% versus 10.6%, p<0.002). The proportion of infants with high neurological risk, patent ductus arteriosus, intraventricular hemorrhage, and days on a ventilator did not differ between the groups. Although infants’ height at 2 months was lower in the HDP group than the control group, other growth and neurodevelopmental outcomes did not differ between the groups. Conclusion: Among preterm infants admitted to the NICU, those born to women with HDP were more likely to be small for gestational age than those of normotensive women. Additional research is needed to optimize care for infants born to women with HDP.

A Systematic Review on Outcomes of Preterm Small for Gestational Infants Born to Women With Hypertensive Disorders in Pregnancy

“…Despite the findings from these studies included in this review, preterm infants born SGA are at risk for short-and long-term health complications, including neurodevelopmental impairment later in life. 14,30,31 Thus, PIH/HDP has long-term consequences for both maternal and infant health.…”

Hypertensive Disorders during Pregnancy (HDP), Maternal Characteristics, and Birth Outcomes among Japanese Women: A Hokkaido Study

“…Mothers with hypertension during pregnancy have a greater risk of developing adverse pregnancy outcomes than normal pregnant women [ 7 ]. Studies conducted in United States, Italy, Canada, Haiti, Malaysia, and Nepal have shown that women with HDP are at double risk of PTB, at three-to four-fold risk of delivering small-for-gestational age (SGA) babies, and their neonates are at a higher risk of being admitted to neonatal intensive care units [ 8 , 9 , 10 , 11 , 12 , 13 ]. PTB has a higher perinatal mortality rate than term birth, whereas SGA has a slow postnatal growth and developmental delay [ 14 ].…”

Comparison of neonatal complications in pre-eclamptic and spontaneous preterm labour in the Persian Gulf Hospital of Bandar Abbas City, Iran, from 2011-2016

“…However, the length at birth was not significantly different in preterm infants of mothers with pre-eclampsia compared to the spontaneous PTL group. In the study by Avorgbedor et al, although mean infant length at 2 months was less in the pre-eclamptic group than the control group, other growth and neurodevelopmental outcomes did not differ between the groups 31 . The study by Fallahian et al showed that in pregnant mothers with hypertension, the weight of infants was 2 times higher than the control group 28 .…”