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Fetal Cerebral Maturation in Hypertensive Disorders of Pregnancy

From the Department of Obstetrical-Gynecological and Perinatal Pathology, Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania; and the Department of Obstetrics and Gynecology, Section of Maternal-Fetal Medicine, Medical College of Georgia, Augusta, Georgia

Abstract

A retrospective search of the perinatal autopsy files at Magee-Womens Hospital of Pittsburgh from 1977 to 1979 disclosed 38 autopsies of preterm infants (gestational age 27 to 34 weeks) born to women with hypertensive disorders. Of these fetuses, 23 were chosen for the study of factors that lead to accelerated cerebral maturation in the preterm fetus. The sequential developmental changes of the individual fissures, sulci, and gyri of the cerebral hemispheres were used to assess gestational development of the brain. Seventeen infants showed accelerated cerebral maturation two weeks or more in advance of gestational age. Six infants showed gyral maturation appropriate for gestational age. Chronic maternal hypertension and fetal intrauterine growth retardation were found to be significant risk factors in accelerated intrauterine cerebral maturation. The chronicity of hypertension may be more important than its severity in accelerated fetal cerebral maturation.

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