title: Maternal hypertensive disorders are associated with increased use of respiratory support but not chronic lung disease or poorer neurodevelopmental outcomes in preterm neonates at <29 weeks of gestation.
abstract: OBJECTIVE
  To assess whether maternal hypertensive disorders in pregnancies result in higher respiratory requirements, risk of chronic lung disease (CLD) and poorer neurodevelopmental outcome in <29-week premature neonates.
  
  
  METHODS
  This is a multicentre, retrospective cohort study, within a geographically defined area in Australia, served by a network of 10 neonatal intensive care units (NICUs), consisting of infants <29 weeks of gestational age who were admitted to NICUs between 1998 and 2004. Outcome measures included hospital survival, perinatal complications and functional disability at 2-3 years follow-up.
  
  
  RESULTS
  A total of 2549 mothers and infants were included in the study; 379 (14.9%) mothers had hypertensive disorders during pregnancy. Follow-up data were obtained for 1473 (74.8%) infants at 2-3 years. Infants exposed to pre-eclampsia had a higher need for supplemental surfactant therapy (odds ratio (OR): 2.004, 95% confidence interval (CI): 1.51-2.66), longer duration of mechanical ventilation (7.0 days vs. 4.0 days), were associated with a higher incidence of CLD (OR: 1.40, 95% CI: 1.12-1.76) and received post-natal steroids for CLD (OR: 1.82, 95% CI: 1.43-2.31) and home oxygen (OR: 1.47, 95% CI: 1.11-1.95). Multivariable analysis showed that hypertensive disease of pregnancy was not significantly associated with the development of CLD in this cohort (OR: 1.103, 95% CI: 0.845-1.441). Multivariable analysis of long-term neurodevelopmental data available for the 1473 follow-up infants showed no significant difference in outcomes with or without exposure to maternal hypertensive disease.
  
  
  CONCLUSIONS
  Maternal hypertensive disease of pregnancy does not increase the risk of CLD or long-term neurodevelopmental complications in infants born at <29 weeks of gestation.
authors.affiliation: Australian National University Medical School, Canberra, Australian Capital Territory, Australia.
authors.forename: Mara
authors.initials: M
authors.lastname: Matić
authors.affiliation: Australian National University Medical School, Canberra, Australian Capital Territory, Australia.
authors.forename: Violet
authors.initials: V
authors.lastname: Inati
authors.affiliation: Australian National University Medical School, Canberra, Australian Capital Territory, Australia.|Department of Neonatology, Centenary Hospital for Women and Children, Canberra, Australian Capital Territory, Australia.
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Abdel-Latif
authors.affiliation: Australian National University Medical School, Canberra, Australian Capital Territory, Australia.|Department of Neonatology, Centenary Hospital for Women and Children, Canberra, Australian Capital Territory, Australia.
authors.forename: Alison L
authors.initials: AL
authors.lastname: Kent
mesh_terms: D000328:Adult; D001315:Australia; D002908:Chronic Disease; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007234:Infant, Premature; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D000068097:Maternal Health; D065886:Neurodevelopmental Disorders / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment
keywords: chronic lung disease; neurodevelopment; pre-eclampsia; preterm neonate