J Korean Med Sci.  2022 Apr;37(16):e127. 10.3346/jkms.2022.37.e127.

Association of Maternal Hypertensive Disorders During Pregnancy With Severe Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

• Lim G
• Kim YJ
• Chung S
• Park YM
• Kim KS
• Park HW

• KMID: 2529294
• DOI: http://doi.org/10.3346/jkms.2022.37.e127

Abstract

Background
This meta-analysis was performed to examine the association between maternal hypertension during pregnancy (HDP) and neonatal bronchopulmonary dysplasia (BPD).
Methods
We systematically searched PubMed, EMBASE, the Cochrane Library, and the KoreaMed database for relevant studies. We used the Newcastle-Ottawa Scale for quality assessment of all included studies. The meta-analysis was performed using Comprehensive Meta-Analysis software (version 3.3).
Results
We included 35 studies that fulfilled the inclusion criteria; the total number of infants evaluated came to 97,399 through review process. Maternal HDP was not significantly associated with any definition of BPD, i.e., oxygen dependency at 36 weeks of gestation (odds ratio [OR], 1.162; 95% confidence interval [CI], 0.991–1.362; P = 0.064) in pooled analysis of 29 studies or oxygen dependency at 28 days of age (OR, 1.084; 95% CI, 0.660–1.780; P = 0.751) in pooled analysis of 8 studies. Maternal HDP was significantly associated only with severe BPD (OR, 2.341; 95% CI, 1.726–3.174; P < 0.001). BPD was not associated with HDP in the overall analysis (OR, 1.131; 95% CI, 0.977–1.309; P = 0.100) or subgroup analysis according to the definition of HDP.
Conclusion
Maternal HDP was not associated with neonatal BPD defined by the duration of oxygen dependency (at either 36 weeks of gestation or 28 days of life) but was associated with severe BPD.

Keyword

Bronchopulmonary Dysplasia; Hypertension; Pregnancy Induced; Infant; Newborn

Figure

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  Fig. 1 Flow diagram of study selection.

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  Fig. 2 Meta-analysis of the relationship between maternal pre-eclampsia and neonatal bronchopulmonary dysplasia: subgroup analysis based on the definition of HDP. Subgroups were defined according to the definition of HDP: subgroup 1, pre-eclampsia and/or eclampsia and/or HELLP; subgroup 2, other HDP except chronic hypertension; subgroup 3, HDP including chronic hypertension.HDP = hypertension during pregnancy, HELLP = hemolysis, elevated liver enzymes, and a low platelet count, CI = confidence interval.

• 

  Fig. 3 Meta-analysis of the relationship between maternal pre-eclampsia and neonatal bronchopulmonary dysplasia defined as an oxygen requirement at 36 weeks of gestational age.HDP = hypertension during pregnancy,, CI = confidence interval.

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  Fig. 4 Meta-analysis of the relationship between maternal pre-eclampsia and neonatal bronchopulmonary dysplasia defined as an oxygen requirement at 28 days of postnatal age.HDP = hypertension during pregnancy, CI = confidence interval.

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  Fig. 5 Meta-analysis of the relationship between maternal pre-eclampsia and severe bronchopulmonary dysplasia.HDP = hypertension during pregnancy, HELLP = hemolysis, elevated liver enzymes and low platelet, CI = confidence interval.

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