Hypertensive disorders of pregnancy contribute to developmental and metabolic multimorbidity in preterm infants.

Preterm birth poses a global health challenge, frequently resulting in complex infant multimorbidity. While the adverse effects of maternal hypertensive disorders of pregnancy (HDP) on offspring are well recognized, their specific impact on distinct multimorbidity patterns in very preterm infants remains underexplored. In this multicenter cohort study, we utilize the Sino-northern Neonatal Network (SNN) database to systematically characterize these profiles. Here we show distinct patterns, including extrauterine growth restriction (EUGR) complicated by parenteral nutrition-associated cholestasis (EUGR-PNAC), congenital hypothyroidism (EUGR-CH), retinopathy of prematurity (EUGR-ROP), and bronchopulmonary dysplasia (EUGR-BPD). Notably, maternal HDP significantly increases the risk of developing these specific patterns. By elucidating these clinical consequences, our study advances the current understanding of the impact of adverse intrauterine exposures on offspring health. Ultimately, these insights highlight the critical need for multidisciplinary screening and management in this high-risk population, providing a crucial foundation for improving long-term neonatal outcomes.