Early-onset preeclampsia/gestational hypertension may be associated with a low incidence of cerebral palsy at 3 years old in singleton very low-birth-weight infants born at 28-31 weeks of gestation (EOPE-DQ study): a multi-center retrospective cohort study in 2013-2016

Hypertens Res. 2024 Oct 8. doi: 10.1038/s41440-024-01929-8. Online ahead of print.

Abstract

Our aim was to evaluate the effects of any types of hypertensive disorders of pregnancy (HDP) on the development of either cerebral palsy (CP) or developmental delay (DD) at 3 years old in singleton very low-birth-weight (VLBW) infants born at 24-31 weeks of gestation. This was a retrospective cohort study of VLBW infants born at 24-31 weeks in 2013-2016 in Japan, using a nationwide obstetrical database, and Neonatal Research Network Japan (NRNJ) Database, accompanied by a secondary survey of women complicated with HDP (EOPE-DQ study). In 529 candidates for long-term follow-up in 7 tertiary centers, the percentage undergoing follow-up for CP at 3 years old was 56.1%, and the percentage receiving follow-up for DD at 3 years old was 54.1%. The percentage of PE/SPE/GH was significantly lower in infants with CP than in controls (1/22 [4.5%] vs. 66/274 [24.1%], p = 0.034); especially, in infants born at 28-31 weeks, the percentage of PE/SPE/GH was significantly lower in infants with CP than in controls (0/13 [0%] vs. 44/151 [29.1%], p = 0.021). The percentage of PE/SPE/GH was not different between infants with DD and controls (9/49 [18.4%] vs. 54/237 [22.8%], p = 0.574). The percentage of composite risk factors (either bronchopulmonary dysplasia at a postmenstrual age of 36 weeks, intraventricular hemorrhage, hypoxic ischemic encephalopathy, sepsis, necrotizing enterocolitis, or periventricular leukomalacia) was significantly higher in infants with DD than in controls. In conclusion, PE/SPE/GH around 30 weeks may be associated with a low incidence of CP.

Keywords: cerebral palsy; developmental delay; gestational hypertension; preeclampsia; very preterm birth.