The Impact of Hypertensive Disorders of Pregnancy on Neonatal Adverse Outcomes and Inflammatory Markers

Background Hypertensive disorders of pregnancy (HDP), including pregnancy-induced hypertension (PIH), mild preeclampsia (MPE), and severe preeclampsia (SPE), significantly impact maternal and neonatal health [1]. These conditions are associated with increased risks of cesarean section, placental abruption, preterm birth, and neonatal inflammation [2]. The inflammatory state of neonates is closely linked to their development and can influence both short-term and long-term health outcomes [3, 4]. However, the specific relationships between HDP and neonatal inflammatory markers remain underexplored. This study aimed to assess inflammation levels in neonates born to mothers with HDP, providing scientific evidence for clinical intervention and management. Methods This study included pregnant women diagnosed with HDP and their neonates at the Zengcheng Branch of Nanfang Hospital from January 2021 to December 2023. Maternal and neonatal characteristics, along with inflammatory markers within the first day of birth, were compared among the PIH (n = 40), MPE (n = 35), and SPE (n = 50) groups. Neonatal development was tracked at 14 and 28 days post-birth. Results Compared with the other groups, the SPE group had a significantly higher incidence of preterm birth, low birth weight, and respiratory distress syndrome ( P  < 0.001). The white blood cell and neutrophil counts were significantly lower in the SPE group than in the PIH and MPE groups ( P  < 0.05). Inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV), were also significantly reduced in the SPE group ( P  < 0.05). Compared with the PIH group, the MPE group presented greater neutrophil counts and PIV ( P  < 0.05). These differences persisted even after adjusting for preterm birth. Additionally, term neonates in the SPE group had significantly lower birth lengths and weights ( P  < 0.05), although no significant differences were observed among the groups at 28 days post-birth. Conclusions Severe preeclampsia significantly affects neonatal inflammatory states and growth, increasing the risk of adverse outcomes. While mild preeclampsia enhances the inflammatory response, severe preeclampsia appears to induce neonatal immunosuppression, potentially increasing the risk of infection and leading to short-term and long-term health complications.