Neonatal respiratory outcomes in pregnancy induced hypertension: introducing a novel index

<b>Objective:</b> To evaluate short-term respiratory outcomes, mortality and bronchopulmonary dysplasia (BPD) in preterm infants born to mothers with and without pregnancy induced hypertension (PIH). <b>Methods:</b> Exposed infants &lt;33 weeks’ gestation were matched to controls in a 1:2 ratio, based on gestation, sex and antenatal steroid exposure in this retrospective cohort study. Primary outcomes were a novel cumulative respiratory index (cRI) (product of mean airway pressure-hours and FiO₂-hours while on invasive ventilation during first 72 hours), mortality and BPD. <b>Results:</b> Seventy-nine exposed infants were matched with 158 controls. cRI was higher in exposed infants (median 1854; IQR 186–13,901) versus controls (median 1359; IQR 210–11,302) but not statistically significant (<i>p</i> = .63). On conditional regression analysis, PIH did not predict cRI (adjusted <i>β</i> = 0.96; 95% CI = 0.79–1.17; <i>p</i> = .712). No association between PIH and mortality (unadjusted odds ratio [OR] = 3.14; 95% CI = 0.76–13.0; <i>p</i>=.11) was identified. PIH was significantly associated with BPD on univariate analysis (OR = 2.29; 95% CI = 1.02–5.17; <i>p</i>=.046), but not after adjustment (aOR = 1.26; 95% CI = 0.38–4.19; <i>p</i>=.7). <b>Conclusions:</b> PIH was not associated with cRI, mortality or BPD in this study. Further validation of cRI and exploration of its relationship with PIH as well as neonatal outcomes is warranted.

**研究目的：** 评估伴与不伴妊娠高血压综合征（PIH）的母亲所生早产儿的短期呼吸系统结局、死亡率及支气管肺发育不良（BPD）。**研究方法：** 本项回顾性队列研究中，依据孕周、性别及产前糖皮质激素暴露情况，按1:2比例将孕周小于33周的暴露组婴儿与对照组婴儿进行匹配。主要结局指标包括新型累积呼吸系统指数（cRI，即最初72小时有创通气期间平均气道压时长与吸入氧浓度时长的乘积）、死亡率及支气管肺发育不良（BPD）。**研究结果：** 共纳入79名暴露组婴儿，匹配158名对照婴儿。暴露组婴儿的cRI更高[中位数1854，四分位间距（IQR）186~13901]，高于对照组[中位数1359，四分位间距210~11302]，但差异无统计学意义（*p*=0.63）。经条件回归分析，妊娠高血压综合征（PIH）无法预测cRI（校正后β=0.96；95%置信区间[CI]：0.79~1.17；*p*=0.712）。未发现妊娠高血压综合征（PIH）与死亡率存在关联（未校正比值比[OR]=3.14；95%置信区间[CI]：0.76~13.0；*p*=0.11）。单因素分析显示，妊娠高血压综合征（PIH）与支气管肺发育不良（BPD）存在显著关联（OR=2.29；95%置信区间[CI]：1.02~5.17；*p*=0.046），但校正后该关联不再显著（校正后比值比[aOR]=1.26；95%置信区间[CI]：0.38~4.19；*p*=0.7）。**研究结论：** 本研究中，妊娠高血压综合征（PIH）与cRI、死亡率及支气管肺发育不良（BPD）均无关联。未来有必要对新型累积呼吸系统指数（cRI）进行进一步验证，并探索其与妊娠高血压综合征（PIH）及新生儿结局的关联。