Department of Neonatology, Centro Hospitalar São João, Porto, Portugal.
Faculty of Medicine, University of Porto, Porto, Portugal.
J Perinatol. 2018 Sep;38(9):1165-1173. doi: 10.1038/s41372-018-0133-8. Epub 2018 May 29.
It is not known whether very preterm infants born to preeclamptic women have worse outcomes than those delivered preterm for other causes.
We assessed the association between preeclampsia (PE) and the neonatal morbidity and mortality of very preterm infants.
Over 2015 and 2016, 11 collaborating Portuguese level III NICUs prospectively enrolled a cohort of mothers with or without PE who delivered liveborn premature infants between 24 and 30 completed weeks of gestation. Data on neonatal morbidities were collected and their association to PE was assessed.
The final cohort consisted of 410 mothers who delivered 494 preterm infants. Infants from PE mothers weighed less than those of non-PE mothers (819 ± 207 g vs. 989 ± 256 g, p < 0.0001). Incidences of respiratory distress syndrome, patent ductus arteriosus, early and nosocomial sepsis, necrotizing enterocolitis, pneumonia, meningitis, retinopathy of prematurity, intraventricular hemorrhage, periventricular infarction, periventricular leukomalacia, and mortality did not differ significantly between infants of PE or non-PE mothers. Incidence of bronchopulmonary dysplasia (BPD-defined as oxygen dependency at 36 weeks) was higher in PE infants compared with non-PE infants by both univariate and multivariate logistic regression (p = 0.007).
We conclude that, when controlling for gestational age, maternal PE results in higher incidence of only BPD among preterm Portuguese infants.
目前尚不清楚患有子痫前期的极早产儿与因其他原因早产的早产儿相比，其结局是否更差。
我们评估了子痫前期（PE）与极早产儿的新生儿发病率和死亡率之间的关系。
在 2015 年至 2016 年期间，11 家合作的葡萄牙三级 NICU 前瞻性地招募了一组患有或不患有 PE 的母亲，这些母亲分娩的早产儿为 24 至 30 周的足月儿。收集了新生儿发病率的数据，并评估了其与 PE 的关系。
最终的队列包括 410 名母亲，她们分娩了 494 名早产儿。PE 母亲的婴儿体重低于非 PE 母亲的婴儿（819±207g 与 989±256g，p<0.0001）。呼吸窘迫综合征、动脉导管未闭、早发性和医院获得性败血症、坏死性小肠结肠炎、肺炎、脑膜炎、早产儿视网膜病变、颅内出血、脑室周围梗死、脑室周围白质软化和死亡率在 PE 或非 PE 母亲的婴儿之间没有显著差异。PE 婴儿的支气管肺发育不良（BPD-定义为 36 周时需要吸氧）发生率高于非 PE 婴儿，这在单变量和多变量逻辑回归中均有体现（p=0.007）。
我们的结论是，在控制胎龄的情况下，母体 PE 仅导致葡萄牙早产儿 BPD 发生率更高。
