Association Between Maternal Hypertension and Infant Neurodevelopment in Extremely Preterm Infants

Abstract 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.