Arch Dis Child Fetal Neonatal Ed 1998;79:F88-F93 ( September )
Maternal hypertension and neurodevelopmental outcome in very
preterm infants
Peter H Gray,a b
Michael J O'Callaghan,b
Heather A Mohay,b
Yvonne R Burns,b
James F Kingc
a Department of Neonatology,
Mater Misericordiae Hospitals, Raymond Terrace
South Brisbane, Queensland 4101, Australia, b Growth and Development
Clinic, c Mater Perinatal Epidemiology Unit
Correspondence to: Dr P H Gray.
Accepted 16 February 1998
AIM
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.
Keywords:
maternal hypertension;
pre-eclampsia;
cerebral
palsy;
neurodevelopment
© 1998 by Archives of Disease in Childhood