Kajdy Anna, Feduniw Stepan, Modzelewski Jan, Sys Dorota, Filipecka-Tyczka Dagmara, Muzyka-Placzyńska Katarzyna, Kiczmer Paweł, Grabowski Bartłomiej, Rabijewski Michał
Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland.
Department and Chair of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
Children (Basel). 2021 Jun 19;8(6):522. doi: 10.3390/children8060522.
(1) Background: Hypertensive disorders of pregnancy (HDP) include gestational hypertension (GH), chronic hypertension (CH), preeclampsia (PE), and preeclampsia superimposed on chronic hypertension (CH with PE). HDP is associated with several short and long-term perinatal and neonatal complications, such as newborn growth restriction and death. This study aimed to establish the association between HDP, newborn growth abnormalities, and neonatal outcome. (2) Methods: This is a single-center retrospective cohort study of 63651 singleton deliveries. (3) Results: Univariate analysis showed a significantly increased risk of intrauterine and neonatal death associated with maternal hypertension and growth disorders. There were differences between growth charts used, with the highest risk of stillbirth for SGA defined by the Intergrowth chart (OR 17.2) and neonatal death for newborn growth restriction (NGR) based on Intergrowth (OR 19.1). Multivariate analysis showed that NGR is a stronger risk factor of neonatal death than SGA only. (4) Conclusions: HDP is significantly associated with growth abnormalities and is an independent risk factor of adverse outcomes. The presence of newborn growth restriction is strongly associated with the risk of neonatal death. The choice of growth chart has a substantial effect on the percentage of diagnosis of SGA and NGR.
(1) 背景：妊娠期高血压疾病（HDP）包括妊娠期高血压（GH）、慢性高血压（CH）、子痫前期（PE）以及慢性高血压合并子痫前期（CH伴PE）。HDP与多种短期和长期围产期及新生儿并发症相关，如新生儿生长受限和死亡。本研究旨在确定HDP、新生儿生长异常与新生儿结局之间的关联。(2) 方法：这是一项对63651例单胎分娩进行的单中心回顾性队列研究。(3) 结果：单因素分析显示，与母亲高血压和生长障碍相关的宫内及新生儿死亡风险显著增加。所使用的生长图表之间存在差异，根据Intergrowth图表定义的小于胎龄儿（SGA）死产风险最高（OR 17.2），基于Intergrowth的新生儿生长受限（NGR）新生儿死亡风险最高（OR 19.1）。多因素分析显示，NGR比单纯SGA更是新生儿死亡的危险因素。(4) 结论：HDP与生长异常显著相关，是不良结局的独立危险因素。新生儿生长受限的存在与新生儿死亡风险密切相关。生长图表的选择对SGA和NGR的诊断百分比有很大影响。
