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



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.


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.


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

Trials Registration: 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:


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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.


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

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Authors and Affiliations




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.

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Correspondence to Martha B. Kole-White.

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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).

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