Maternal hypertension improves neonatal physiology and survival in small for gestational age infants admitted to the neonatal intensive care unit (NICU).
Recent studies have suggested that small for gestational age infants of mothers with mild untreated pregnancy-induced hypertension fare better than small for gestational age infants whose mothers are not hypertensive or whose hypertensive mothers receive treatment, the authors explain.
Dr. Laura Ann Magee, from British Columbia Women’s Hospital and Health Centre, Vancouver, and colleagues used data from the Canadian Neonatal Network database to investigate the relationship between maternal hypertension and neonatal outcomes.
Maternal hypertension was associated with a greater likelihood of a healthier neonate (as measured by the Score of Neonatal Acute Physiology, SNAP), the authors report.
Survival was nearly doubled among small for gestational age infants admitted to the NICU whose mothers were hypertensive, the results indicate, and there was a suggestion of increased survival without severe intraventricular hemorrhage among infants of hypertensive mothers.
In contrast, the researchers note, a lower likelihood of a healthier neonate was associated with antenatal steroid treatment, low gestational age, poor 5-minute Apgar score, male gender, and major/minor congenital anomalies.
"This study supports a growing body of evidence that maternal hypertension, particularly pregnancy-induced hypertension, may serve some adaptive role for the fetus in the face of uteroplacental dysfunction," the authors write.
"This has implications for clinical management, for it follows that it must not be automatically assumed that normalization of mild-to-moderate hypertension in pregnancy is of greater benefit than risk to the fetus," the investigators suggest.
Obstet Gynecol 2005;106:335-339.
DID YOU KNOW:
Link Between Socioeconomic Status and Insulin Resistance Differs by Country: Findings from a study of insulin resistance in Europe suggest that high earnings and an advanced educational level do not always translate into good health.In Denmark, children of the most educated and highest earning parents showed the least insulin resistance. By contrast, in Estonia and Portugal, just the opposite was seen. In the Danish group, children of the most educated fathers had 24% lower insulin resistance than children of the least educated fathers.