Elevated Blood Pressure in Newborns From Hypertensive Disorders of Pregnancy During the Immediate Postnatal Period

FIGURE 1. Study population. Clinical data were obtained for maternal‐infant dyads cared for at Nebraska Medicine between 2012 and 2025. After applying inclusion and exclusion criteria and filtering for missing covariate data, 1655 dyads were included in the study population.

FIGURE 2. Impact of maternal hypertensive disorders of pregnancy on measures of newborn heart rate. The forest plot displays β coefficients (points) and 95% confidence intervals (horizontal lines) for the association between HDP and newborn heart rate (HR) and HR variability expressed in beats per minute (bpm). Estimates were obtained using inverse probability weighted regression adjustment (IPWRA) adjusted for maternal diabetes during pregnancy, in utero tobacco exposure, delivery mode, newborn sex, gestational age, maternal overweight and obesity status, and advanced maternal age. Positive β coefficients indicate higher values in the HDP groups relative to controls. Statistical significance compared to normotension is defined as p < 0.05 as indicated by 95% confidence intervals that do not cross the null value (β = 0; dashed line). Statistically significant differences between GH, PE, and CH groups are defined as p < 0.05 as indicated by 95% confidence intervals that do not overlap.

FIGURE 3. Impact of maternal hypertensive disorders of pregnancy on measures of newborn blood pressure. The forest plot displays β coefficients (points) and 95% confidence intervals (horizontal lines) for the association between HDP and newborn mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and SBP and DBP variability expressed in mmHg. Estimates were obtained using inverse probability weighted regression adjustment (IPWRA) adjusted for maternal diabetes during pregnancy, in utero tobacco exposure, delivery mode, newborn sex, gestational age, maternal overweight and obesity status, and advanced maternal age. Positive β coefficients indicate higher values in the HDP groups relative to controls. Statistical significance compared to normotension is defined as p < 0.05 as indicated by 95% confidence intervals that do not cross the null value (β = 0; dashed line). Statistically significant differences between GH, PE, and CH groups are defined as p < 0.05 as indicated by 95% confidence intervals that do not overlap.

FIGURE 4. Cardiovascular risk in offspring of hypertensive disorders of pregnancy. HDP induces inflammation, oxidative stress, and endothelial dysfunction in utero, which may disrupt fetal vascular development and program early cardiovascular dysfunction. These alterations are detectable at birth in elevated blood pressures and may contribute to the elevated blood pressure and increased cardiovascular disease risk in children and adolescents from HDP. Over time, these early disruptions may contribute to the elevated incidence of cardiovascular disease and adverse cardiovascular events in adulthood, consistent with the developmental origins of health and disease (DOHaD) theory.