Hypertensive disorders of pregnancy and outcomes of preterm infants of 24 to 28 weekś gestation

L. Gemmell, L. Martin, K. E. Murphy, N. Modi, S. Håkansson, B. Reichman, K. Lui, S. Kusuda, G. Sjörs, L. Mirea, B. A. Darlow, R. Mori, S. K. Lee, P. S. Shah*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

Objective:To examine the relationship between hypertensive disorders of pregnancy (HDPs) and mortality and major morbidities in preterm neonates born at 24 to 28 weeks of gestation.Study Design:Using an international cohort, we retrospectively studied 27 846 preterm neonates born at 24 0 to 28 6 weeks of gestation during 2007 to 2010 from 6 national neonatal databases. The incidence of HDP was compared across countries, and multivariable logistic regression analyses were conducted to examine the association of HDP and neonatal outcomes including mortality to discharge, bronchopulmonary dysplasia, severe brain injury, necrotizing enterocolitis and treated retinopathy of prematurity.Results:The incidence of HDP in the entire cohort was 13% (range 11 to 16% across countries). HDP was associated with reduced odds of mortality (adjusted odds ratio (aOR) 0.77; 95% confidence interval (CI) 0.67 to 0.88), severe brain injury (aOR 0.74; 95% CI 0.62 to 0.89) and treated retinopathy (aOR 0.82; 95% CI 0.70 to 0.96), but increased odds of bronchopulmonary dysplasia (aOR 1.16; 95% CI 1.05 to 1.27).Conclusions:In comparison with neonates born to mothers without HDP, neonates of HDP mothers had lower odds of mortality, severe brain injury and treated retinopathy, but higher odds of bronchopulmonary dysplasia. The impact of maternal HDP on newborn outcomes was inconsistent across outcomes and among countries; therefore, further international collaboration to standardize terminology, case definition and data capture is warranted.

Original languageEnglish
Pages (from-to)1067-1072
Number of pages6
JournalJournal of Perinatology
Volume36
Issue number12
DOIs
StatePublished - 1 Dec 2016
Externally publishedYes

Funding

FundersFunder number
Canadian Institutes of Health Research and Mount Sinai Hospital, Toronto, ON, Canada
Israel Center for Disease Control
Israel Neonatal Network
Swedish Neonatal Quality Register
Ministerio de Sanidad, Consumo y Bienestar Social
Canadian Institutes of Health ResearchAPR-126340
Canadian Institutes of Health Research
Ministry of Health, Labour and Welfare
Socialdepartementet

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