Maternal Hypertension Linked to Neurodevelopment Deficits in Preterm Infants

Women with maternal hypertension who birth preterm infants incur a risk for that child having adverse neurodevelopment around 2 years of age, according to a study in JAMA Network Open.

Preeclampsia impacts up 5% of all pregnancies and has been linked with premature birth as well as neurodevelopmental deficits, owing to placental ischemia, hypoxia, inflammation, and oxidative stress, as noted by the investigators. Hypertensive disorders of pregnancy (HDP) stand as a broader category which includes preeclampsia, gestational hypertension, and chronic hypertension. HDP affects between 5-15% of pregnancies, and its prevalence is increasing. HDP exposure is correlated with suboptimal neurodevelopment in full-term infants; however, less is known about how it impacts preterm babies.

To address this knowledge gap, the investigators assessed the link between maternal HDP and neurodevelopment in only preterm infants (born at 32 weeks or less). The analysis consisted of 395 preterm infants, all from the Cincinnati Infant Neurodevelopment Early Prediction Study. All infants with chromosomal or congenital anomalies affecting the central nervous system, cyanotic heart disease, or poor-quality brain magnetic resonance imaging (MRI) scans were excluded from analysis.

The researchers performed structural brain MRI at term equivalent age, and neurodevelopment was analyzed by Bayley Scales of Infant and Toddler Development (BSID) between 22- and 26-months’ corrected age. The primary outcome of interest was the association of HDP and preeclampsia on cognitive development, while secondary endpoints assessed language and motor development.

Findings Highlight the Need for Targeted Interventions

The findings of the analysis showed that HDP exposure was negatively associated with BSID cognitive scores (−3.69; 95% CI, −6.69 to −0.68; P = .02) as well as language scores (−4.07; 95% CI, −8.03 to −0.11; P = .04). The investigators noted that preeclampsia exposure showed even greater correlations for BSID scores (−4.85; 95% CI, −8.63 to −1.07; P = .01 for cognitive and −6.30; 95% CI, −11.49 to −1.09; P = .02 for language scores).

“Our findings thus support an association between maternal high blood pressure and early brain abnormalities and potentially harmful direct effects on cognitive and language development,” remarked lead author Shipra Jain, MD, via a press release about the study. “We believe early identification of brain abnormalities can allow for targeted interventions, such as early speech therapy, occupational therapy, or enriched learning environments, which can improve long-term educational, behavioral, and health outcomes, especially when preeclampsia occurs.”

Source:

1. Jain S, et al. JAMA Netw Open. 2025;8(4):e257788. Doi: 10.1001/jamanetworkopen.2025.7788