Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.
Pediatr Res. 2019 Apr;85(5):693-696. doi: 10.1038/s41390-019-0336-5. Epub 2019 Feb 15.
Preeclampsia (PE) is a pregnancy complication characterized by an anti-angiogenic environment. This can affect fetal pulmonary vascular and alveolar development but data of the impact of PE on respiratory outcome in extremely premature infants are inconclusive. The objective of this study was to determine if PE is associated with an increased risk for severe respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) in extremely premature infants.
Prospectively collected single center data from a cohort of infants born at 23-28 w gestational age between January 2005 and December 2015 were analyzed. Logistic regression analysis and generalized estimating equations were used to model the association between PE and severe RDS (≥30% supplemental oxygen on d1), BPD and severe BPD [supplemental oxygen and ≥30% oxygen at 36 w postmenstrual age (PMA), respectively].
The cohort included 1218 infants of whom 23% were exposed to PE. PE was associated with increased risk for severe RDS as well as severe BPD among infants alive at 36w PMA.
Exposure to preeclampsia is independently associated with an increased risk for severe RDS and adverse respiratory outcome in extreme premature infants. The mechanisms behind these associations need to be investigated.
子痫前期（PE）是一种妊娠并发症，其特征是抗血管生成环境。这可能会影响胎儿肺血管和肺泡的发育，但子痫前期对极早产儿呼吸结局影响的数据尚无定论。本研究的目的是确定 PE 是否与极早产儿重度呼吸窘迫综合征（RDS）和支气管肺发育不良（BPD）的风险增加有关。
对 2005 年 1 月至 2015 年 12 月期间在 23-28 周胎龄出生的队列中前瞻性收集的单中心数据进行分析。使用逻辑回归分析和广义估计方程来模拟 PE 与重度 RDS（≥1 天 30%补充氧气）、BPD 和严重 BPD[补充氧气和 36 周校正胎龄（PMA）≥30%氧气，分别]之间的关联。
该队列包括 1218 名婴儿，其中 23%的婴儿接触过 PE。PE 与存活至 36 周 PMA 的婴儿重度 RDS 和重度 BPD 的风险增加有关。
子痫前期的暴露与极早产儿重度 RDS 和不良呼吸结局的风险增加独立相关。需要研究这些关联背后的机制。
