Hypertensive Disease of Pregnancy Connection with Bronchopulmonary Dysplasia

Children’s Hospital Colorado neonatologist Erica Wymore, MD, is looking closer at the impact of severe hypertensive disease of pregnancy (HDP), such as preeclampsia, on infants. In particular, she's exploring the association between HDP and bronchopulmonary dysplasia (BPD) in infants. BPD is the chronic lung disease of prematurity, often requiring long periods of ventilatory support from weeks to months.

Dr. Wymore’s most recent study analyzed a cohort of 693 mother-infant pairs. For the purposes of the study, she defined severe HDP as severe preeclampsia, HELLP syndrome or eclampsia. The results showed that infants born at less than 25 weeks’ gestation to parents with severe HDP had a higher likelihood of developing moderate-severe BPD compared to their counterparts with standard blood pressures — almost two times higher. Babies born at 28 or 29 weeks’ gestation did not have the same increased risk.

“We know there is an abnormal sort of vascular process that results in preeclampsia that affects the placenta,” Dr. Wymore explains. “We also know in lung disease of prematurity, the blood vessels in the lungs aren’t normal in the baby’s developing lungs. Both have a vascular origin story, and this supports that vascular hypothesis.”

This research is made possible by a multidisciplinary group based out of the University of Colorado’s Department of Ophthalmology where Dr. Wymore is the neonatology collaborator. The team has created a database of maternal and infant data for infants born prematurely.

This new research will allow the team to better counsel families dealing with HDP prior to birth by educating them on their baby’s higher risk of lung disease and providing a clearer picture of what to expect during their NICU stay. It also opens the door for more research in the future.

“These findings demonstrate that there’s something going on between this vascular disease of pregnancy and the subsequent risk in the fetus, so that’s where our basic science researchers can investigate further to find out if there are any targets for therapies to treat these mothers earlier or more aggressively,” Dr. Wymore says.