Our objective was to compare the outcome of premature infants of mothers with preeclampsia and hypertension with properly matched controls to examine whether infants of mothers with preeclampsia are at a lesser risk. We designed a retrospective cohort study of 99 infants of mothers with preeclampsia and hypertension (IHM) at < or = 36 weeks' gestation. Infants of nonhypertensive women matched for gestational age, gender, asphyxia, maternal diabetes mellitus, twin gestation, and mode of delivery served as controls. Data were analyzed by dividing all cases into three gestational age groups: group I, 26 to 30 weeks' gestation (IHM n = 21, control n = 39); group II, 31 to 33 weeks (IHM n = 32, control n = 61); and group III, 34 to 36 weeks (IHM n = 46). Because detailed data on nonhypertensive infants at 34 to 36 weeks' gestation were available only for intensive care unit admissions, group III was excluded from the comparative analysis. The incidence of hyaline membrane disease was significantly lower in IHM compared with the controls in groups I and II (group I, 19.1% vs 46.2%, p < 0.005; group II, 12.5% vs 32.8%, p < 0.04). Symptomatic patent ductus arteriosus occurred less frequently in groups I and II compared with controls (group I, 28.6% vs 46.2%, p < 0.001; group II, 3.1% vs 13.1%, p < 0.005). Intraventricular hemorrhage was less frequent in group I compared with controls (4.8% vs 20.5%, p < 0.001). The incidence of intraventricular hemorrhage in group II was similar at 3.1% versus 1.6% for controls.(ABSTRACT TRUNCATED AT 250 WORDS)