Maternal hypertension and survival without bronchopulmonary dysplasia in preterm infants: a meta-analysis of cohort studies.
Siyi Wang, Huan Yu, Changyi Li et al.
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In 30 seconds
This random-effects meta-analysis of cohort studies examined associations between hypertensive disorders of pregnancy (HDP) and outcomes in preterm infants. Of 21 included studies, HDP was associated with lower survival without bronchopulmonary dysplasia (BPD) (RR 0.875, 95% CI 0.818, 0.935) and higher BPD risk (RR 1.211, 95% CI 1.101, 1.332). No significant association with perinatal mortality was found (RR 1.005, 95% CI 0.781, 1.291). Stratified analyses indicated that gestational age, publication year, and geographic region may partly account for variation across studies.
Key findings
- HDP was associated with reduced survival without BPD (RR 0.875, 95% CI 0.818, 0.935).
- HDP was associated with increased BPD risk (RR 1.211, 95% CI 1.101, 1.332).
- There was no significant association between HDP and perinatal mortality (RR 1.005, 95% CI 0.781, 1.291).
- Gestational age, publication year, and geographic region may partly explain heterogeneity in prior findings.
Why it matters
The findings suggest that infants born preterm after pregnancies complicated by HDP may have greater BPD risk and lower likelihood of survival without BPD. This association can inform awareness of pulmonary outcomes in this population, while the absence of a significant mortality association distinguishes respiratory morbidity from perinatal survival in the pooled evidence.
What to keep in mind
The meta-analysis included cohort studies, so the reported associations do not establish that HDP causes BPD or reduced survival without BPD. The abstract also notes heterogeneity across studies.