title: Maternal hypertension and neonatal outcome among small for gestational age infants.
abstract: OBJECTIVE
  To determine whether maternal hypertension might improve perinatal outcome among small for gestational age (SGA) infants (< 10th percentile).
  
  
  METHODS
  Our prospective cohort comprised 17 Canadian neonatal intensive care units (NICUs) and 3,244 SGA singletons. Multivariable regression was used to analyze the relation between maternal hypertension and each of the following: SNAP-II (Score of Neonatal Acute Physiology; ordinal regression) and neonatal survival and survival without severe intraventricular hemorrhage (logistic regression), adjusting for potential confounders.
  
  
  RESULTS
  There were 698 (21.5%) neonates born to hypertensive mothers. Inversely associated with lower SNAP-II scores (healthier infant) were antenatal steroids (complete course: odds ratio [OR] 0.67, 95% confidence interval [CI] 0.54-0.83; incomplete: OR 0.71, 95% CI 0.56-0.88), lower gestational age (< 27 weeks: OR 0.06, 95% CI 0.05-0.08; 27-28 weeks: OR 0.11, 95% CI 0.07-0.17; 29-32 weeks: OR 0.28, 95% CI 0.23-0.35), 5-minute Apgar < 7 (OR 0.30, 95% CI 0.25-0.36), male gender (OR 0.80, 95% CI 0.70-0.92), and anomalies (OR 0.49, 95% CI 0.41-0.58). Maternal hypertension was associated with lower SNAP-II (healthier infant) (7.54 +/- 11.16 [hypertensive] versus 7.21 +/- 11.85 [normotensive]) on multivariable regression analysis (adjusted OR 1.25, 95% CI 1.05-1.49), as well as higher neonatal survival (93.0% versus 91.2%, and adjusted OR 1.9, 95% CI 1.2-3.0), but not survival without severe intraventricular hemorrhage (91.4% versus 87.0%, and adjusted OR 1.4, 95% CI 1.0-2.0), respectively.
  
  
  CONCLUSIONS
  Among SGA neonates in NICU, maternal hypertension is associated with improved admission neonatal physiology and survival.
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: von Dadelszen
authors.forename: Laura Ann
authors.initials: LA
authors.lastname: Magee
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Taylor
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Muir
authors.forename: Shawn D
authors.initials: SD
authors.lastname: Stewart
authors.forename: Paul
authors.initials: P
authors.lastname: Sherman
authors.forename: Shoo K
authors.initials: SK
authors.lastname: Lee
mesh_terms: D002543:Cerebral Hemorrhage / Q000209:etiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology*; D007236:Infant, Small for Gestational Age; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies