Skip to main content
PMC home page
Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 1998 Sep;79(2):F88–F93. doi: 10.1136/fn.79.2.f88

Maternal hypertension and neurodevelopmental outcome in very preterm infants

P Gray, M O'Callaghan, H Mohay, Y Burns, J King
PMCID: PMC1720840  PMID: 9828732

Abstract

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.



Full Text

The Full Text of this article is available as a PDF (120.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BAX M. C. TERMINOLOGY AND CLASSIFICATION OF CEREBRAL PALSY. Dev Med Child Neurol. 1964 Jun;6:295–297. doi: 10.1111/j.1469-8749.1964.tb10791.x. [DOI] [PubMed] [Google Scholar]
  2. Banias B. B., Devoe L. D., Nolan T. E. Severe preeclampsia in preterm pregnancy between 26 and 32 weeks' gestation. Am J Perinatol. 1992 Sep-Nov;9(5-6):357–360. doi: 10.1055/s-2007-999264. [DOI] [PubMed] [Google Scholar]
  3. Brown M. A., Buddle M. L. Hypertension in pregnancy: maternal and fetal outcomes according to laboratory and clinical features. Med J Aust. 1996 Oct 7;165(7):360–365. doi: 10.5694/j.1326-5377.1996.tb125017.x. [DOI] [PubMed] [Google Scholar]
  4. Catanzarite V., Quirk J. G., Aisenbrey G. How do perinatologists manage preeclampsia? Am J Perinatol. 1991 Jan;8(1):7–10. doi: 10.1055/s-2007-999327. [DOI] [PubMed] [Google Scholar]
  5. Derham R. J., Hawkins D. F., De Vries L. S., Aber V. R., Elder M. G. Outcome of pregnancies complicated by severe hypertension and delivered before 34 weeks; stepwise logistic regression analysis of prognostic factors. Br J Obstet Gynaecol. 1989 Oct;96(10):1173–1181. doi: 10.1111/j.1471-0528.1989.tb03193.x. [DOI] [PubMed] [Google Scholar]
  6. Grether J. K., Nelson K. B., Emery E. S., 3rd, Cummins S. K. Prenatal and perinatal factors and cerebral palsy in very low birth weight infants. J Pediatr. 1996 Mar;128(3):407–414. doi: 10.1016/s0022-3476(96)70292-5. [DOI] [PubMed] [Google Scholar]
  7. Hagberg G., Hagberg B., Olow I. The changing panorama of cerebral palsy in Sweden 1954-1970. III. The importance of foetal deprivation of supply. Acta Paediatr Scand. 1976 Jul;65(4):403–408. doi: 10.1111/j.1651-2227.1976.tb04906.x. [DOI] [PubMed] [Google Scholar]
  8. Harms K., Rath W., Herting E., Kuhn W. Maternal hemolysis, elevated liver enzymes, low platelet count, and neonatal outcome. Am J Perinatol. 1995 Jan;12(1):1–6. doi: 10.1055/s-2007-994387. [DOI] [PubMed] [Google Scholar]
  9. Jonas O., Stern L. M., Macharper T. A South Australian study of pregnancy and birth risk factors associated with cerebral palsy. Int J Rehabil Res. 1989;12(2):159–166. doi: 10.1097/00004356-198906000-00004. [DOI] [PubMed] [Google Scholar]
  10. Kitchen W. H., Robinson H. P., Dickinson A. J. Revised intrauterine growth curves for an Australian hospital population. Aust Paediatr J. 1983 Sep;19(3):157–161. doi: 10.1111/j.1440-1754.1983.tb02082.x. [DOI] [PubMed] [Google Scholar]
  11. Korkman M., Hilakivi-Clarke L. A., Autti-Rämö I., Fellman V., Granström M. L. Cognitive impairments at two years of age after prenatal alcohol exposure or perinatal asphyxia. Neuropediatrics. 1994 Apr;25(2):101–105. doi: 10.1055/s-2008-1071594. [DOI] [PubMed] [Google Scholar]
  12. Kuban K. C., Leviton A., Pagano M., Fenton T., Strassfeld R., Wolff M. Maternal toxemia is associated with reduced incidence of germinal matrix hemorrhage in premature babies. J Child Neurol. 1992 Jan;7(1):70–76. doi: 10.1177/088307389200700113. [DOI] [PubMed] [Google Scholar]
  13. Martikainen A. Growth and development at the age of 1.5 years in children with maternal hypertension. J Perinat Med. 1989;17(4):259–269. doi: 10.1515/jpme.1989.17.4.259. [DOI] [PubMed] [Google Scholar]
  14. McCowan L. M., Buist R. G., North R. A., Gamble G. Perinatal morbidity in chronic hypertension. Br J Obstet Gynaecol. 1996 Feb;103(2):123–129. doi: 10.1111/j.1471-0528.1996.tb09662.x. [DOI] [PubMed] [Google Scholar]
  15. Murphy D. J., Sellers S., MacKenzie I. Z., Yudkin P. L., Johnson A. M. Case-control study of antenatal and intrapartum risk factors for cerebral palsy in very preterm singleton babies. Lancet. 1995 Dec 2;346(8988):1449–1454. doi: 10.1016/s0140-6736(95)92471-x. [DOI] [PubMed] [Google Scholar]
  16. Murphy D. J., Squier M. V., Hope P. L., Sellers S., Johnson A. Clinical associations and time of onset of cerebral white matter damage in very preterm babies. Arch Dis Child Fetal Neonatal Ed. 1996 Jul;75(1):F27–F32. doi: 10.1136/fn.75.1.f27. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Nelson K. B., Ellenberg J. H. Antecedents of cerebral palsy. I. Univariate analysis of risks. Am J Dis Child. 1985 Oct;139(10):1031–1038. doi: 10.1001/archpedi.1985.02140120077032. [DOI] [PubMed] [Google Scholar]
  18. Nelson K. B., Grether J. K. Can magnesium sulfate reduce the risk of cerebral palsy in very low birthweight infants? Pediatrics. 1995 Feb;95(2):263–269. [PubMed] [Google Scholar]
  19. O'Callaghan M. J., Burns Y., Gray P., Harvey J. M., Mohay H. I., Rogers Y., Tudehope D. I. Extremely low birth weight and control infants at 2 years corrected age: a comparison of intellectual abilities, motor performance, growth and health. Early Hum Dev. 1995 Jan 30;40(2):115–128. doi: 10.1016/0378-3782(94)01597-I. [DOI] [PubMed] [Google Scholar]
  20. Ounsted M. K., Moar V. A., Good F. J., Redman C. W. Hypertension during pregnancy with and without specific treatment; the development of the children at the age of four years. Br J Obstet Gynaecol. 1980 Jan;87(1):19–24. doi: 10.1111/j.1471-0528.1980.tb04420.x. [DOI] [PubMed] [Google Scholar]
  21. Palmer L., Blair E., Petterson B., Burton P. Antenatal antecedents of moderate and severe cerebral palsy. Paediatr Perinat Epidemiol. 1995 Apr;9(2):171–184. doi: 10.1111/j.1365-3016.1995.tb00132.x. [DOI] [PubMed] [Google Scholar]
  22. Rogers B., Msall M., Owens T., Guernsey K., Brody A., Buck G., Hudak M. Cystic periventricular leukomalacia and type of cerebral palsy in preterm infants. J Pediatr. 1994 Jul;125(1):S1–S8. doi: 10.1016/s0022-3476(94)70169-5. [DOI] [PubMed] [Google Scholar]
  23. Schendel D. E., Berg C. J., Yeargin-Allsopp M., Boyle C. A., Decoufle P. Prenatal magnesium sulfate exposure and the risk for cerebral palsy or mental retardation among very low-birth-weight children aged 3 to 5 years. JAMA. 1996 Dec 11;276(22):1805–1810. [PubMed] [Google Scholar]
  24. Shankaran S., Bauer C. R., Bain R., Wright L. L., Zachary J. Prenatal and perinatal risk and protective factors for neonatal intracranial hemorrhage. National Institute of Child Health and Human Development Neonatal Research Network. Arch Pediatr Adolesc Med. 1996 May;150(5):491–497. doi: 10.1001/archpedi.1996.02170300045009. [DOI] [PubMed] [Google Scholar]
  25. Shennan A. T., Dunn M. S., Ohlsson A., Lennox K., Hoskins E. M. Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period. Pediatrics. 1988 Oct;82(4):527–532. [PubMed] [Google Scholar]
  26. Spinillo A., Iasci A., Capuzzo E., Egbe T. O., Colonna L., Fazzi E. Two-year infant neurodevelopmental outcome after expectant management and indicated preterm delivery in hypertensive pregnancies. Acta Obstet Gynecol Scand. 1994 Sep;73(8):625–629. doi: 10.3109/00016349409013455. [DOI] [PubMed] [Google Scholar]
  27. Szymonowicz W., Yu V. Y. Severe pre-eclampsia and infants of very low birth weight. Arch Dis Child. 1987 Jul;62(7):712–716. doi: 10.1136/adc.62.7.712. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Taylor D. J., Howie P. W., Davidson J., Davidson D., Drillien C. M. Do pregnancy complications contribute to neurodevelopmental disability? Lancet. 1985 Mar 30;1(8431):713–716. doi: 10.1016/s0140-6736(85)91261-9. [DOI] [PubMed] [Google Scholar]
  29. Tubman T. R., Rollins M. D., Patterson C., Halliday H. L. Increased incidence of respiratory distress syndrome in babies of hypertensive mothers. Arch Dis Child. 1991 Jan;66(1 Spec No):52–54. doi: 10.1136/adc.66.1_spec_no.52. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Tudehope D. I., Masel J., Mohay H., O'Callaghan M., Burns Y., Rogers Y., Williams G. Neonatal cranial ultrasonography as predictor of 2 year outcome of very low birthweight infants. Aust Paediatr J. 1989 Apr;25(2):66–71. doi: 10.1111/j.1440-1754.1989.tb01418.x. [DOI] [PubMed] [Google Scholar]
  31. van Bel F., van de Bor M., Stijnen T., Ruys J. H. Decreased cerebrovascular resistance in small for gestational age infants. Eur J Obstet Gynecol Reprod Biol. 1986 Nov;23(3-4):137–144. doi: 10.1016/0028-2243(86)90141-3. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood. Fetal and Neonatal Edition are provided here courtesy of BMJ Publishing Group

RESOURCES