(204) Does maternal chronic hypertension increase the risk for offspring long-term respiratory morbidity?

Thursday, January 30, 2025

10:30 AM – 12:30 PM

Submitting Author and Presenting Author(s)

Gil Gutvirtz, MD

Soroka University Medical Center
Metar, HaDarom, Israel

Coauthor(s)

Tamar Wainstock, PhD (she/her/hers)

Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Beer Sheva, HaDarom, Israel
Eyal Sheiner, MD, PhD

Head of department of Obstetrics and Gynecology, Soroka University Medical Center
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Beer Sheva, HaDarom, Israel

Objective: Maternal chronic hypertension has been associated with various adverse pregnancy and neonatal outcomes, including superimposed preeclampsia and preterm labor. Both complications have been shown to expose the offspring for both short and long-term adverse consequences. However, most studies investigating offspring long-term outcomes included mothers with all types of hypertensive disorders of pregnancy and did not discern them from mothers with preexisting disease. We decided to explore a possible association between maternal chronic hypertension and long-term respiratory morbidity of the offspring.

Study Design: A population-based retrospective cohort study comparing offspring of mothers with and without chronic hypertension or any hypertensive disorders. We included singleton deliveries that took place between the years 1991-2021 at a tertiary center. Offspring long-term (up to 18 years) respiratory morbidity was compared using registered diagnoses from hospitalization of the offspring involving a respiratory disease. A Kaplan–Meier survival curve was used to compare the cumulative incidence of respiratory morbidity, and a Cox regression model was constructed to control for confounders.

Results: A total of 342,365 singleton deliveries were included. Among them 3,097 (0.9%) were deliveries of mothers with chronic hypertension. The total respiratory morbidity rate of children exposed to maternal chronic hypertension was significantly higher than children from pregnancies without hypertensive disorders (Table). However, the cumulative incidence of respiratory morbidity over time was comparable between the groups (Figure). Furthermore, using the Cox regression model, controlling for maternal and gestational age, the association between maternal chronic hypertension and long-term respiratory morbidity of the offspring was no longer significant (Table).

Conclusion: In our cohort, although the crude rates of respiratory morbidity are higher for exposed offspring, careful analysis found that maternal chronic hypertension is not an independent risk factor for offspring long-term respiratory morbidity.