open access
Perinatal and neonatal outcome in patients with preeclampsia
, 2, 3, 1, 1, 2, 2, 1, 4, 1, 2, 5
Affiliations- Department of Obstetrics, Medical University of Gdansk, Poland
- Department of Medical Immunology, Medical University of Gdansk, Poland
- Department of Neonatology Medical University of Gdansk, Poland
- Department of Endocrinology and Internal Medicine, Medical University of Gdansk, Poland
- International Centre for Cancer Vaccine Science Cancer Immunology Group, University of Gdansk, Poland
open access
Abstract
Objectives: Preeclampsia (PE) affects 2–5% of pregnant women. Hypertensive disorders of pregnancy are associated with adverse maternal and perinatal outcomes. Material and methods: This study included 88 women showing gestational hypertension (GH) or PE symptoms, and their newborns. Results: The rate of FGR was 43% for mothers with PE, compared to 8% with GH. The association was significant, p = < 0.001 but with moderate strength, Cramer’s V = 0.40. The risk of FGR increased nine times when PE occurred, as the odds ratio was 9.25 (CI: 2.46–34.83), p = 0.001. PE was associated with FGR risk if delivery time was less than 34 weeks compared to a delivery time of more than 34 weeks. This was 82% of FGR cases for < 34 weeks, compared with 35% of cases in > 34 group, (p = 0.001; Cramer’s V = 0.50). PE was also associated (p = 0.01, Cramer’s V = 0.27) with the type of delivery, as the caesarean section rate was 74%, compared to 50% in the GH group. This made it three times higher the likelihood of delivery by caesarean section, as the odds ratio was 3.10 (CI: 1.24–7.75), p=0,02. Delivery time was significantly (p < 0.001) shortened to 38 weeks (27–41), compared to 40 weeks (38–42) GH mothers. There was no distinction in median age for PE and GH mothers (p = 0.124). The overall clinical status of neonates was proportional despite the mother’s PE. The sum of Apgar points in the first, and then the second to third minute, did not differ significantly, p = 0.370 and 0.560, respectively. The number of peripheral blood platelets and leucocytes was not reduced (p = 0.821 and 0.534) in infants when the mother suffered from PE. Conclusions: The prediction of adverse maternal outcomes from hypertensive diseases of pregnancy is key to optimal management, including the timing of delivery and planning for the most appropriate place of care.
Abstract
Objectives: Preeclampsia (PE) affects 2–5% of pregnant women. Hypertensive disorders of pregnancy are associated with adverse maternal and perinatal outcomes. Material and methods: This study included 88 women showing gestational hypertension (GH) or PE symptoms, and their newborns. Results: The rate of FGR was 43% for mothers with PE, compared to 8% with GH. The association was significant, p = < 0.001 but with moderate strength, Cramer’s V = 0.40. The risk of FGR increased nine times when PE occurred, as the odds ratio was 9.25 (CI: 2.46–34.83), p = 0.001. PE was associated with FGR risk if delivery time was less than 34 weeks compared to a delivery time of more than 34 weeks. This was 82% of FGR cases for < 34 weeks, compared with 35% of cases in > 34 group, (p = 0.001; Cramer’s V = 0.50). PE was also associated (p = 0.01, Cramer’s V = 0.27) with the type of delivery, as the caesarean section rate was 74%, compared to 50% in the GH group. This made it three times higher the likelihood of delivery by caesarean section, as the odds ratio was 3.10 (CI: 1.24–7.75), p=0,02. Delivery time was significantly (p < 0.001) shortened to 38 weeks (27–41), compared to 40 weeks (38–42) GH mothers. There was no distinction in median age for PE and GH mothers (p = 0.124). The overall clinical status of neonates was proportional despite the mother’s PE. The sum of Apgar points in the first, and then the second to third minute, did not differ significantly, p = 0.370 and 0.560, respectively. The number of peripheral blood platelets and leucocytes was not reduced (p = 0.821 and 0.534) in infants when the mother suffered from PE. Conclusions: The prediction of adverse maternal outcomes from hypertensive diseases of pregnancy is key to optimal management, including the timing of delivery and planning for the most appropriate place of care.
Keywords
preeclampsia; gestational hypertension; complications; neonates; perinatal outcome; neonatal outcome
About this articleTitle
Perinatal and neonatal outcome in patients with preeclampsia
Journal
Issue
Article type
Research paper
Pages
203-208
Published online
2021-05-13
Page views
5950
Article views/downloads
1141
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(3):203-208.
Keywords
preeclampsia
gestational hypertension
complications
neonates
perinatal outcome
neonatal outcome
Authors
Katarzyna A. Stefanska
Maciej Zielinski
Joanna Jassem-Bobowicz
Dorota Zamkowska
Przemyslaw Adamski
Karolina Piekarska
Martyna Jankowiak
Katarzyna Leszczynska
Renata Swiatkowska-Stodulska
Krzysztof Preis
Piotr Trzonkowski
Natalia Marek-Trzonkowska
References (22)- Poon LC, Shennan A, Hyett JA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019; 145(Suppl 1): 1–33.
- Ronsmans C, Graham WJ. Lancet Maternal Survival Series steering group. Maternal mortality: who, when, where, and why. Lancet. 2006; 368(9542): 1189–1200.
- Kuklina EV, Ayala C, Callaghan WM. Hypertensive disorders and severe obstetric morbidity in the United States. Obstet Gynecol. 2009; 113(6): 1299–1306.
- Brown M, Magee L, Kenny L, et al. Hypertensive disorders of pregnancy. Hypertension. 2018; 72(1): 24–43.
- Magee LA, Pels A, Helewa M, et al. Canadian Hypertensive Disorders of Pregnancy (HDP) Working Group. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregnancy Hypertens. 2014; 4(2): 105–145.
- Lowe SA, Bowyer L, Lust K, et al. Society of Obstetric Medicine of Australia and New Zealand. The SOMANZ guidelines for the management of hypertensive disorders of pregnancy 2014. Aust N Z J Obstet Gynaecol. 2015; 55(1): 11–16.
- Lisonkova S, Sabr Y, Mayer C, et al. Maternal morbidity associated with early-onset and late-onset preeclampsia. Obstet Gynecol. 2014; 124(4): 771–781.
- Bokslag A, van Weissenbruch M, Mol BW, et al. Preeclampsia; short and long-term consequences for mother and neonate. Early Hum Dev. 2016; 102: 47–50.
- Mendola P, Mumford SL, Männistö TI, et al. Controlled direct effects of preeclampsia on neonatal health after accounting for mediation by preterm birth. Epidemiology. 2015; 26(1): 17–26.
- Vogel JP, Souza JP, Mori R, et al. Maternal complications and perinatal mortality: findings of the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG: An International Journal of Obstetrics & Gynaecology. 2014; 121(Suppl 1): 76–88.
- von Dadelszen P, Magee LA. Preventing deaths due to the hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol. 2016; 36: 83–102.
- Backes CH, Markham K, Moorehead P, et al. Maternal preeclampsia and neonatal outcomes. J Pregnancy. 2011; 2011: 214365.
- Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet. 2008; 371(9608): 261–269.
- Khalil A, Syngelaki A, Maiz N, et al. Maternal age and adverse pregnancy outcome: a cohort study. Ultrasound in Obstetrics & Gynecology. 2013; 42(6): 634–643.
- Lamminpää R, Vehviläinen-Julkunen K, Gissler M, et al. Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997–2008. BMC Pregnancy Childbirth. 2012; 12: 47.
- Balasch J, Gratacós E. Delayed childbearing. Current Opinion in Obstetrics & Gynecology. 2012; 24(3): 187–193.
- Poon LCY, Kametas NA, Chelemen T, et al. Maternal risk factors for hypertensive disorders in pregnancy: a multivariate approach. J Hum Hypertens. 2010; 24(2): 104–110.
- Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005; 330(7491): 565.
- Liu L, Hong Z, Zhang L. Associations of prepregnancy body mass index and gestational weight gain with pregnancy outcomes in nulliparous women delivering single live babies. Sci Rep. 2015; 5: 12863.
- Rahman MM, Abe SK, Kanda M, et al. Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis. Obes Rev. 2015; 16(9): 758–770.
- Wei YM, Yang HX, Zhu WW, et al. Risk of adverse pregnancy outcomes stratified for pre-pregnancy body mass index. J Matern Fetal Neonatal Med. 2016; 29(13): 2205–2209.
- Yücesoy G, Ozkan S, Bodur H, et al. Maternal and perinatal outcome in pregnancies complicated with hypertensive disorder of pregnancy: a seven year experience of a tertiary care center. Arch Gynecol Obstet. 2005; 273(1): 43–49.
