95: Neonatal Outcomes in Infants <29 Weeks Gestation in Relation to Maternal Hypertension and Smoking Status

Abstract

Maternal hypertension and cigarette smoking during pregnancy are associated with adverse neonatal outcomes. Paradoxically, smoking during pregnancy is associated with a reduced incidence of gestational hypertension. However, mothers who smoke during pregnancy and develop hypertension have worse pregnancy outcomes as compared to mothers who only have hypertension or non-smoking normotensive mothers. There is little data on neonatal outcomes of infants born to mothers with hypertension who also smoke. To study the outcomes of infants of mothers with hypertension who smoke. Using the Canadian Neonatal Network Database, we analyzed the outcomes of infants <29 weeks GA admitted to Canadian NICUs from 2003–2012. Infants were divided into four groups. Group 0 comprised infants of hypertensive mothers who smoked, group 1 infants of non-smoking hypertensive mothers, group 2 infants of normotensive mothers who smoked and group 3 infants of normotensive non-smoking mothers. Composite outcome of neonatal mortality or any of the major morbidities {grade 3/4 intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), retinopathy of prematurity (ROP) > stage 2, late onset sepsis (LOS) or bronchopulmonary dysplasia (BPD) was assessed using a multivariable model. Of the 12,307 eligible infants, 172 were in group 0, 1689 in group 1, 1535 in group 2 and 8911 in group 3. Adjusted ORs with 95% CIs with reference to group 3 (normotensive, non-smokers) are reported in Table 1. Infants of hypertensive mothers, whether smokers or non-smokers, were associated with higher rates of BPD. Smoking cessation campaigns during pregnancy are needed for both maternal and neonatal benefits.