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Maternal hypertensive disorders and survival without major morbidities among extremely low gestation newborns

Journal of Perinatology volume 43, pages 430–436 (2023)Cite this article

Subjects

Abstract

Objective

Evaluate if odds of survival without major morbidity are higher among extremely low gestation neonates (ELGANs) born to mothers with chronic hypertension (cHTN) or hypertensive disorders of pregnancy (HDP) compared to ELGANs born to mothers without hypertension (HTN).

Study design

Retrospective study of prospectively collected data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Included children had a birthweight of 401–1000 g and/or gestational age of 220/7 to 286/7 wks. The primary outcome was survival to discharge without major morbidity. Multivariable regression models were used to compare outcomes among ELGANs born to women with cHTN, HDP, and no HTN.

Results

Survival without morbidities for newborns of mothers with no HTN, cHTN and HDP (29.1%, 32.9%, 37.0% respectively) did not differ after adjustment.

Conclusion

After adjusting for contributing variables maternal HTN is not associated with improved survival free of morbidity among ELGANs.

Trials Registration: clinicaltrials.gov Identifier: NCT00063063 (generic database)

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Fig. 1: Participant exclusion and inclusion.

Data availability

Data from this active and ongoing registry study can be requested at: https://neonatal.rti.org/index.cfm?fuseaction=DataRequest.Home.

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Acknowledgements

The National Institutes of Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Center for Advancing Translational Sciences (NCATS) provided grant support for the Neonatal Research Network’s Generic Database Study through cooperative agreements. While NICHD staff had input into the study design, conduct, analysis, and manuscript drafting, the comments and views of the authors do not necessarily represent the views of NICHD, the National Institutes of Health, the Department of Health and Human Services, or the U.S. Government. Participating NRN sites collected data and transmitted it to RTI International, the data coordinating center (DCC) for the network, which stored, managed and analyzed the data for this study. On behalf of the NRN, RTI International had full access to all of the data in the study, and with the NRN Center Principal Investigators, takes responsibility for the integrity of the data and accuracy of the data analysis. We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study.

Funding

Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA.

Author information

Authors and Affiliations

  1. Division of Maternal Fetal Medicine, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, RI, US

    Martha B. Kole-White

  2. Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, Durham, NC, US

    Shampa Saha

  3. Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA, US

    Erika F. Werner

  4. Department of Pediatrics, Central Michigan University, Wayne State University, Detroit, MI, US

    Sanjay Chawla

  5. Department of Pediatrics, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, RI, US

    Martin Keszler, Elisabeth C. McGowan & Abbot R. Laptook

  6. Department of Pediatrics, UT Southwestern Medical Center at Dallas, Dallas, TX, US

    Myra H. Wyckoff & Myra Wyckoff

Authors
  1. Martha B. Kole-White
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  2. Shampa Saha
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  4. Sanjay Chawla
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  5. Martin Keszler
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  6. Elisabeth C. McGowan
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  7. Myra H. Wyckoff
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  8. Abbot R. Laptook
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Consortia

Generic Database Subcommittee of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

  • Sanjay Chawla
  • , Martin Keszler
  • , Abbot R. Laptook
  • , Elisabeth C. McGowan
  •  & Myra Wyckoff

Contributions

MKW, EW and AL conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. SS contributed to the design of the study, performed initial and subsequent data analysis, and revised the manuscript. SC, MK, EM, and MW contributed to designing the study and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Martha B. Kole-White.

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The authors declare no competing interests.

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Kole-White, M.B., Saha, S., Werner, E.F. et al. Maternal hypertensive disorders and survival without major morbidities among extremely low gestation newborns. J Perinatol 43, 430–436 (2023). https://doi.org/10.1038/s41372-023-01631-6

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  • DOI: https://doi.org/10.1038/s41372-023-01631-6

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