Perinatal & Pediatric
Associations Between Maternal Hypertensive Disorders of Pregnancy and Vascular Birthmark Development in Infants Jessica J. Wong* Jessica Wong Yajnaseni Chakraborti Ellen C. Caniglia David Margolis Enrique Schisterman Sunni L. Mumford Stefanie N. Hinkle
Background: Investigating the developmental origins of vascular birthmarks, such as port-wine stains (PWS) and hemangiomas, in the context of hypertensive disorders of pregnancy (HDP), offers a unique lens to explore the relationship between maternal health and infant dermatological outcomes. While often considered cosmetic, these birthmarks can signify serious conditions like Sturge-Weber Syndrome in facial PWS cases or vision impairment from hemangiomas near the eyes. Recognizing the shared developmental pathways between hemangiomas and preeclampsia (PE), this study examined the association between HDP and vascular birthmarks.
Methods: The Collaborative Perinatal Project (1959-1966) was a prospective study at 12 US clinical centers. Contemporary clinical guidelines defined HDP as chronic hypertension (HT), gestational HT, PE/eclampsia, and superimposed PE. Vascular birthmarks were diagnosed in infants at one year by general practitioners. Adjusted log-binomial regression models with multiple imputations for missing data estimated the association between HDP and infantile birthmarks, adjusting for confounders.
Results: Of 55,676 maternal-infant pairs, 50,487 were normotensive, 2,087 had chronic HT, 943 had gestational HT, 519 had PE, and 1,011 had superimposed PE. At one year, 1.3% of infants had hemangiomas, and 0.5% had PWS. For PWS, the RRs (95% CI) were 1.12 (0.48-1.76) for chronic HT, 1.01 (0.22-1.8) for gestational HT, 1.34 (0.35-2.34) for PE, and 2.25 (1.56-2.94) for superimposed PE. For hemangiomas, the RRs were 1.38 (0.98-1.78) for chronic HT, 1.01 (0.52-1.51) for gestational HT, 1.75 (1.2-2.3) for PE, and 0.95 (0.31-1.58) for superimposed PE.
Conclusion: This study suggests that superimposed PE could be associated with an increased risk of developing PWS, while PE might be linked to an increased risk of hemangiomas. These observations highlight the need for further exploration into the role of HT in the development of vascular birthmarks in infants.