Bossung Verena, Fortmann Mats Ingmar, Fusch Christoph, Rausch Tanja, Herting Egbert, Swoboda Isabelle, Rody Achim, Härtel Christoph, Göpel Wolfgang, Humberg Alexander
Department of Obstetrics and Gynaecology, University Hospital of Schleswig-Holstein, Lübeck, Germany.
Department of Paediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany.
Front Pediatr. 2020 Oct 12;8:579293. doi: 10.3389/fped.2020.579293. eCollection 2020.
To analyze short term outcomes of very low birth weight infants (VLBWI) born preterm after maternal preeclampsia and HELLP syndrome within the German Neonatal Network. The German Neonatal Network is a large population-based cohort study enrolling VLBWI since 2009. Two thousand six hundred and fifty two infants below 32 weeks of gestation born after maternal preeclampsia or HELLP syndrome and 13,383 infants born prematurely for other causes between 2009 and 2018 were included in our analysis. Descriptive statistics and multinomial regression models including preeclampsia and HELLP syndrome were performed for short-term outcome measures such as intracerebral hemorrhage, necrotizing enterocolitis requiring surgery, bronchopulmonary dysplasia, retinopathy of prematurity, periventricular leukomalacia, persistent ductus arteriosus requiring surgery, blood culture positive sepsis and death. After adjustment for confounding variables, preterm birth due to preeclampsia or HELLP syndrome was associated with a reduced risk for intracerebral hemorrhage (OR 0.73, 95% CI 0.60-0.89), necrotizing enterocolitis requiring surgery (OR 0.35 95% CI 0.15-0.82), periventricular leukomalacia (OR 0.61 95% CI 0.40-0.92), and death (OR 0.72 95% CI 0.55-0.96) as compared to other causes of preterm birth. The indication for preterm birth has an impact on neonatal outcome in preterm infants born below 32 weeks. This notion should be included when counseling the families.
分析德国新生儿网络中,患有子痫前期和HELLP综合征的母亲所分娩的极低出生体重早产儿(VLBWI)的短期结局。德国新生儿网络是一项基于大规模人群的队列研究,自2009年起纳入VLBWI。2009年至2018年间,我们分析了2652例孕周小于32周、母亲患有子痫前期或HELLP综合征的婴儿,以及13383例因其他原因早产的婴儿。针对脑出血、需要手术的坏死性小肠结肠炎、支气管肺发育不良、早产儿视网膜病变、脑室周围白质软化、需要手术的动脉导管未闭、血培养阳性败血症和死亡等短期结局指标,进行了描述性统计和包括子痫前期和HELLP综合征在内的多项回归模型分析。在对混杂变量进行调整后,与其他早产原因相比,子痫前期或HELLP综合征导致的早产与脑出血风险降低(比值比0.73,95%置信区间0.60-0.89)、需要手术的坏死性小肠结肠炎(比值比0.35,95%置信区间0.15-0.82)、脑室周围白质软化(比值比0.61,95%置信区间0.40-0.92)和死亡(比值比0.72,95%置信区间0.55-0.96)相关。早产指征对孕周小于32周的早产儿的新生儿结局有影响。在为家庭提供咨询时应考虑这一观点。