Hypertensive Disorders during Pregnancy and Risk of Bronchopulmonary Dysplasia in Very Preterm Infants

Gustavo Marcondes Rocha; Filipa Flor de Lima; Ana Paula Machado; Hercília Areias Guimarães; Hypertensive Disorders of Pregnancy Study Group

doi:10.1055/s-0038-1660865

American Journal of Perinatology, Table of Contents

Am J Perinatol 2019; 36(02): 176-183
DOI: 10.1055/s-0038-1660865

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hypertensive Disorders during Pregnancy and Risk of Bronchopulmonary Dysplasia in Very Preterm Infants

Gustavo Marcondes Rocha

¹Department of Neonatology, Centro Hospitalar São João, Porto, Portugal

,

Filipa Flor de Lima

¹Department of Neonatology, Centro Hospitalar São João, Porto, Portugal

²Faculty of Medicine, University of Porto, Porto, Portugal

,

Ana Paula Machado

³Department of Obstetrics and Gynaecology, Centro Hospitalar São João, Porto, Portugal

,

Hercília Areias Guimarães

¹Department of Neonatology, Centro Hospitalar São João, Porto, Portugal

²Faculty of Medicine, University of Porto, Porto, Portugal

,

Hypertensive Disorders of Pregnancy Study Group

(

Elisa Proença

⁴Centro Materno Infantil do Norte, Porto, Portugal

,

Carmen Carvalho

⁴Centro Materno Infantil do Norte, Porto, Portugal

,

Luís Guedes Martins

⁴Centro Materno Infantil do Norte, Porto, Portugal

,

Teresa Martins

⁵(Hospital Pedro Hispâno, Matosinhos, Portugal

,

Alice Freitas

⁶Hospital da Senhora da Oliveira, Guimarães, Portugal

,

Clara Paz Dias

⁶Hospital da Senhora da Oliveira, Guimarães, Portugal

,

Albina Silva

⁷Hospital de Braga, Braga, Portugal

,

Almerinda Barroso

⁷Hospital de Braga, Braga, Portugal

,

Isabel Diogo

⁸Centro Hospitalar Lisboa Central, Maternidade Dr Alfredo da Costa, Lisboa, Portugal

,

Gonçalo Cassiano

⁸Centro Hospitalar Lisboa Central, Maternidade Dr Alfredo da Costa, Lisboa, Portugal

,

Helena Ramos

⁸Centro Hospitalar Lisboa Central, Maternidade Dr Alfredo da Costa, Lisboa, Portugal

,

Maria Margarida Abrantes

⁹Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal

,

Paula Costa

⁹Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal

,

Anabela Salazar

¹⁰Centro Hospitalar Lisboa Ocidental, Hospital São Francisco Xavier, Lisboa, Portugal

,

Filipa Vieira

¹⁰Centro Hospitalar Lisboa Ocidental, Hospital São Francisco Xavier, Lisboa, Portugal

,

Dora Fontes

¹⁰Centro Hospitalar Lisboa Ocidental, Hospital São Francisco Xavier, Lisboa, Portugal

,

Rosalina Barroso

¹¹Hospital Prof. Dr Fernando Fonseca, Amadora, Portugal

,

Tânia Marques

¹¹Hospital Prof. Dr Fernando Fonseca, Amadora, Portugal

,

Vera Santos

¹²Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal

,

Ecaterina Scortenschi

¹²Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal

,

Celeste Santos

¹²Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal

,

Fernanda Vilela

¹²Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal

,

Conceição Quintas

¹³Centro Hospitalar de Vila Nova de Gaia/ Espinho, Hospital de Vila Nova de Gaia, Vila Nova de Gaia, Portugal

)› Author Affiliations

Abstract

Introduction It is not yet fully known whether hypertensive disorders (HTD) during pregnancy impose an increased risk of development of bronchopulmonary dysplasia (BPD) in preterm newborn infants.

Objective To test the hypothesis that preeclampsia and other HTD are associated with the development of BPD in preterm infants.

Materials and Methods Data on mothers and preterm infants with gestational age 24 to 30 weeks were prospectively analyzed in 11 Portuguese level III centers. Statistical analysis was performed using IBM SPSS statistics 23.

Results A total of 494 preterm infants from 410 mothers were enrolled, and 119 (28%) of the 425 babies, still alive at 36 weeks, developed BPD. The association between chronic arterial hypertension, chronic arterial hypertension with superimposed preeclampsia, and gestational hypertension in mothers and BPD in preterm infants was not significant (p = 0.115; p = 0.248; p = 0.060, respectively). The association between preeclampsia–eclampsia and BPD was significant (p = 0.007). The multivariate analysis revealed an association between preeclampsia–eclampsia and BPD (odds ratio [OR] = 4.6; 95% confidence interval [CI] 1.529–13.819; p = 0.007) and a protective effect for BPD when preeclampsia occurred superimposed on chronic arterial hypertension in mothers (OR = 0.077; 95%CI 0.009–0.632; p = 0.017).

Conclusion The results of this study support the association of preeclampsia in mothers with BPD in preterm babies and suggest that chronic hypertension may be protective for preterm babies.

Keywords

hypertensive disorders of pregnancy - preeclampsia - preterm newborn - bronchopulmonary dysplaisa - perinatology

Full Text

References

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