Maternal hypertension and neurodevelopmental outcome in very preterm infants.
OBJECTIVE
To determine the outcome of preterm infants born to mothers with hypertension during pregnancy, and preterm controls.


METHODS
107 infants of 24-32 weeks gestation, born to hypertensive mothers, and 107 controls matched for gestational age, sex, and multiple pregnancy, born to normotensive mothers, were prospectively enrolled over 2 years. Information on maternal complications and medication was obtained and neonatal mortality and morbidities recorded. Survivors were followed up to at least 2 years, corrected for prematurity.


RESULTS
One third of the hypertensive mothers were treated with antihypertensive drugs, while 18% received convulsion prophylaxis with phenytoin. Magnesium sulphate was not prescribed. Both groups had a mean gestational age of 29.9 weeks, with the study infants having a significantly lower birthweight than the controls. Four study and three control infants died in the neonatal period. Cerebral palsy was not diagnosed in any infant of a hypertensive mother compared with five of the controls. The mean general quotient for the two groups was very similar and no difference in the incidence of minor neuromotor developmental problems was shown.


CONCLUSIONS
Maternal hypertension seems to protect against cerebral palsy in preterm infants without increasing the risk of cognitive impairment. This was independent of the use of maternally administered magnesium sulphate.
Gray
P H
PH
Department of Neonatology, Mater Misericordiae Hospitals, South Brisbane, Queensland, Australia.
O'Callaghan
M J
MJ
Mohay
H A
HA
Burns
Y R
YR
King
J F
JF
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000401:mortality / Q000517:prevention & control*; D002675:Child, Preschool; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000517:prevention & control*; D010672:Phenytoin / Q000627:therapeutic use; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D015996:Survival Rate
D000927:Anticonvulsants; D000959:Antihypertensive Agents; D010672:Phenytoin