Axt R, Boos R, Babayan A, Ertan K, Schmidt W
Universitäts-Frauenklinik und Poliklinik mit Hebammenlehranstalt Homburg/Saar.
Z Geburtshilfe Neonatol. 2000 Mar-Apr;204(2):49-54. doi: 10.1055/s-2000-10196.
To determine the effect of hypertensive disorders in pregnancy on the neonatal outcome of growth restricted fetuses. There is conflicting data on the effect of hypertension during pregnancy on the incidence of neonatal respiratory distress syndrome (RDS) and intraventricular hemorrhage. Some studies report a lower incidence of RDS and intraventricular hemorrhage in infants of hypertensive mothers, whereas other studies report a similar or higher incidence in infants born to hypertensive mothers.
We performed a retrospective analysis of 220 growth restricted fetuses born between January 1, 1996 to July 1, 1997 at the Department of Obstetrics and Gynecology of the University-Hospital at Homburg/Saar. Data were obtained by review of the medical records. Growth restricted infants born to preeclamptic women or women with HELLP syndrome were compared to growth restricted fetuses born to mothers without hypertensive disorders.
Growth restricted fetuses born to hypertensive mothers had a significant lower birth weight (p < 0.05). The incidence of RDS in children born to hypertensive mothers was significantly higher (p < 0.05, p < 0.01) and they stayed significantly longer in the neonatal intensive care unit (p < 0.01). In contrast to infants born to mothers with HELLP syndrome (n = 7) there was no difference in the incidence of intraventricular hemorrhage, infection, sepsis, necrotizing enterocolitis or cardiac complications (arrhythmia, insufficiency) in case of preeclampsia (n = 68). The perinatal mortality of infants born to hypertensive mothers was significantly higher (p < 0.05, p < 0.01).
This study does not support the contention that hypertensive disorders in pregnancy have a beneficial effect on the postnatal course of IUGR infants.
确定妊娠期高血压疾病对生长受限胎儿新生儿结局的影响。关于孕期高血压对新生儿呼吸窘迫综合征（RDS）和脑室内出血发生率的影响，数据存在冲突。一些研究报告称，高血压母亲的婴儿患RDS和脑室内出血的发生率较低，而其他研究则报告高血压母亲所生婴儿的发生率相似或更高。
我们对1996年1月1日至1997年7月1日在洪堡/萨尔大学医院妇产科出生的220例生长受限胎儿进行了回顾性分析。数据通过查阅病历获得。将子痫前期妇女或患有HELLP综合征的妇女所生的生长受限婴儿与无高血压疾病的母亲所生的生长受限胎儿进行比较。
高血压母亲所生的生长受限胎儿出生体重显著较低（p<0.05）。高血压母亲所生孩子患RDS的发生率显著更高（p<0.05，p<0.01），并且他们在新生儿重症监护病房的停留时间显著更长（p<0.01）。与HELLP综合征母亲所生婴儿（n = 7）相比，子痫前期（n = 68）情况下脑室内出血、感染、败血症、坏死性小肠结肠炎或心脏并发症（心律失常、功能不全）的发生率没有差异。高血压母亲所生婴儿的围产期死亡率显著更高（p<0.05，p<0.01）。
本研究不支持妊娠期高血压疾病对小于胎龄儿出生后病程有有益影响这一观点。
