Association between maternal hypertension and infant neurodevelopment in extremely preterm infants

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.