INFANT NEURODEVELOPMENTAL OUTCOME IN PREGNANCIES COMPLICATED BY GESTATIONAL HYPERTENSION AND INTRAUTERINE GROWTH-RETARDATION

The neonatal outcome of 78 consecutive singleton pregnancies complicat ed by intrauterine growth retardation (IUGR) and gestational hypertens ion were compared with the outcome of 78 adequately matched pregnancie s complicated by idiopathic IUGR. The rate of low (< 5) 1-minute Apgar scores was higher in infants born to hypertensive mothers (12.8% vs 2 .6% p = .035). No differences in the prevalence of other perinatal fac tors such as acidosis, respiratory distress syndrome, hypoglycemia, pn eumothorax, bronchopulmonary dysplasia, intracranial hemorrhage, requi rement for assisted ventilation or survival were found between cases a nd controls. After two years' follow-up, the rate of major neurologica l neonatal handicaps, was 2.8% in the cases and 1.4% in the controls ( p = 0.56). Mild neurodevelopmental abnormalities were more frequent in infants born to hypertensive mothers (14.3% vs 2.9% p = .025). After adjustment by multiple logistic regression, to eliminate the effect of confounding factors, the probability of normal neurodevelopmental out come was reduced by 82% in infants born to hypertensive mothers as com pared to controls (Odds Ratio = 0.18; 95% confidence interval 0.05 to 0.82 p = .028). These findings suggest that pregnancies complicated by IUGR and gestational hypertension are associated with a high prevalen ce of subsequent neurodevelopmental problems among infants.