HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by von Dadelszen, P. Search for Related Content PubMed PubMed Citation Articles by von Dadelszen, P. Related Collections Hypertension and PIH Medical complications of pregnancy Pediatrics/neonatology

Maternal Hypertension and Neonatal Outcome Among Small for Gestational Age Infants

From the Department of Obstetrics and Gynaecology, University of British Columbia, and BC Women's Hospital and Health Centre, Vancouver; Centre for Healthcare Innovation and Improvement, British Columbia Research Institute for Children's and Women's Health, University of British Columbia, Vancouver; Department of Medicine, University of British Columbia, and BC Women's Hospital and Health Centre, Vancouver; Department of Neurobiology and Behavior, Mudd Hall, Cornell University, Ithaca, New York; and Department of Paediatrics, University of British Columbia, Vancouver, British Columbia.

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.

Conclusion: Among SGA neonates in NICU, maternal hypertension is associated with improved admission neonatal physiology and survival.

Level of Evidence: II-2

This article has been cited by other articles:

				R. O. Powrie A 30-Year-Old Woman With Chronic Hypertension Trying to Conceive JAMA, October 3, 2007; 298(13): 1548 - 1558. [Abstract] [Full Text] [PDF]

				N Evans, J Hutchinson, J M Simpson, D Donoghue, B Darlow, D Henderson-Smart, and on behalf of the Australian and New Zealand Neonat Prenatal predictors of mortality in very preterm infants cared for in the Australian and New Zealand Neonatal Network Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2007; 92(1): F34 - F40. [Abstract] [Full Text] [PDF]

				A. Bageris and T. Cohen Maternal Hypertension and Neonatal Outcome Among Small for Gestational Age Infants Obstet. Gynecol., December 1, 2005; 106(6): 1416 - 1416. [Full Text] [PDF]