Maternal Hypertension in Very-Low-Birth-Weight Infants

Kim et al¹ find that infants born to mothers with mild maternal hypertension had fewer pulmonary complications than control infants or infants born to mothers with severe maternal hypertension. Neurobiologic features are suggested by reports linking the induction of breathing with dopamine lateralized to the right hemisphere and subclinical impairment of lung airways caused by airway smooth-muscle tone dysregulation by dopamine abnormalities induced by hypoxia.^2,3 This hypothesis is supported by prenatal stress that reduces dopamine turnover in the right nucleus accumbens leading to depression in adult offspring⁴ and by optimal response organization at intermediate dopamine tone in a mediofrontostriatal activation system.⁵

These findings prompt a follow-up to assess whether these more optimal neonatal findings in infants born to mothers with mild maternal hypertension will be reflected in their long-term outcomes¹ by monitoring behavioral correlates of asymmetrical brain functions, reflecting properties of neuronal activity and firing.