Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
Pregnancy Hypertens. 2020 Jan;19:131-137. doi: 10.1016/j.preghy.2020.01.006. Epub 2020 Jan 14.
Possible impact of maternal hypertension and preeclampsia on neonatal respiratory disorders was unknown. We investigated the association of maternal hypertension and preeclampsia with neonatal respiratory disorders in preterm and full-term newborns.
In this study, we used a large Chinese population-based study which includes 185,687 singleton livebirths with gestational weeks between 28 and 42 weeks. The "exposure" was maternal hypertension and preeclampsia. The outcome was neonatal respiratory disorders including neonatal respiratory distress syndrome (NRDS), pneumonia and low Apgar scores. Logistic regression was used to examine the association between the maternal hypertensive disorders and the risk for neonatal respiratory disorders. We further evaluated the association in preterm and full-term infants.
As a result, the incidence of neonatal RDS, pneumonia, and low Apgar score in hypertensive group was higher than that in normotensive group. Preeclampsia was associated with RDS [(adjusted relative risk (aRR): 1.85, 95% confidence interval (CI): 1.22-3.05)]. Both maternal hypertension and preeclampsia increased risks for neonatal pneumonia (aRR: 1.79, 95%CI: 1.48-2.17; aRR: 1.81, 95%CI: 1.36-2.40, respectively), for low Apgar score at 1 min (aRR: 1.20, 95%CI: 1.13-1.27; aRR: 1.53, 95%CI: 1.41-1.67, respectively), and for low Apgar score at 5 min (aRR: 1.30, 95%CI: 1.17-1.45; aRR: 1.70, 95%CI: 1.46-1.99, respectively). The risk for neonatal respiratory disorders increased with severity of maternal hypertension. The observed associations were present in both full-term and preterm birth.
Maternal hypertension and preeclampsia are risk factors for neonatal respiratory disorders in full-term and preterm newborns.
母体高血压和子痫前期对新生儿呼吸障碍的可能影响尚不清楚。我们研究了母体高血压和子痫前期与早产儿和足月儿新生儿呼吸障碍的关系。
本研究采用了一项大型的中国人群基础研究，共纳入了 185687 例 28-42 周单胎活产儿。“暴露”因素为母体高血压和子痫前期。结局为新生儿呼吸障碍，包括新生儿呼吸窘迫综合征（NRDS）、肺炎和低 Apgar 评分。采用 logistic 回归分析母体高血压疾病与新生儿呼吸障碍风险之间的关系。我们进一步评估了早产儿和足月儿的关联。
结果显示，高血压组新生儿 RDS、肺炎和低 Apgar 评分的发生率高于正常血压组。子痫前期与 RDS 相关（调整后的相对风险[aRR]：1.85，95%置信区间[CI]：1.22-3.05）。母体高血压和子痫前期均增加了新生儿肺炎的风险（aRR：1.79，95%CI：1.48-2.17；aRR：1.81，95%CI：1.36-2.40），1 分钟时 Apgar 评分低（aRR：1.20，95%CI：1.13-1.27；aRR：1.53，95%CI：1.41-1.67）和 5 分钟时 Apgar 评分低（aRR：1.30，95%CI：1.17-1.45；aRR：1.70，95%CI：1.46-1.99）。新生儿呼吸障碍的风险随着母体高血压的严重程度而增加。在足月和早产出生中均观察到了这些关联。
母体高血压和子痫前期是足月和早产儿新生儿呼吸障碍的危险因素。
