Maternal hypertension and survival without bronchopulmonary dysplasia in preterm infants: a meta-analysis of cohort studies

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BACKGROUND: The association between hypertensive disorders of pregnancy (HDP) and bronchopulmonary dysplasia (BPD) in preterm infants remains controversial due to inconsistent findings in previous studies. However, systematic studies and meta-analyses evaluating the association remain limited. METHODS: The study followed the Meta-analysis of Observational Studies in Epidemiology (PRISMA) reporting guideline. The PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and the Chinese Science and Technology Periodical Database (VPCS) databases were searched from January 1997 to October 2024. Search terms included gestational hypertension, preeclampsia, eclampsia, or superimposed preeclampsia on chronic hypertension; bronchopulmonary dysplasia; Premature Birth; and Stillbirth, Fetal Death or Perinatal Mortality. A random-effects meta-analysis model was used to clarify the relationships between HDP and 1) survival without BPD, 2) BPD, and 3) perinatal mortality. RESULTS: A total of 29538 publications were found, of which 21 were included in the meta-analysis. HDP was associated with reduced survival without BPD (RR 0.875, 95% CI 0.818, 0.935) and increased BPD risk (RR 1.211, 95% CI 1.101, 1.332), while no significant link with perinatal mortality (RR 1.005, 95% CI 0.781, 1.291). Stratified analyses suggested that gestational age, publication year, and geographic region may partly explain the heterogeneity among previous findings. CONCLUSIONS: HDP negatively correlates with survival without BPD and positively correlates with BPD in preterm infants, underscoring the need for targeted postnatal pulmonary monitoring.

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