Department of Women and Children's Health, King's College London, London, UK.
Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
BJOG. 2024 Jan;131(1):88-98. doi: 10.1111/1471-0528.17574. Epub 2023 Jun 19.
To quantify maternal hypertensive disorder of pregnancy (HDP) prevalence in late preterm and term infants admitted to neonatal units (NNU) and assess opportunities to avoid admissions.
A retrospective population-based study using the National Neonatal Research Database.
England and Wales.
Infants born ≥34 weeks' gestation admitted to NNU between 2012 and 2020.
Outcomes in HDP infants are compared with non-HDP infants using regression models.
Hypertensive disorder of pregnancy, primary reason for admission, clinical diagnoses and resource use.
16 059/136 220 (11.8%) of late preterm (34 to 36 weeks' gestation) and 14 885/284 646 (5.2%) of term (≥37 weeks' gestation) admitted infants were exposed to maternal HDP. The most common primary reasons for HDP infant admission were respiratory disease (28.3%), prematurity (22.7%) and hypoglycaemia (16.4%). HDP infants were more likely to be admitted with primary hypoglycaemia than were non-HDP infants (odds ratio [OR] 2.1, 95% confidence interval [CI] 2.0-2.2, P < 0.0001). 64.5% of HDP infants received i.v. dextrose. 35.7% received mechanical or non-invasive ventilation. 8260/30 944 (26.7%) of HDP infants received intervention for hypoglycaemia alone (i.v. dextrose) with no other major intervention (respiratory support, parenteral nutrition, central line, arterial line or blood transfusion).
The burden of maternal HDP on late preterm and term admissions to NNU is high, with hypoglycaemia and respiratory disease being the main drivers for admission. Over one in four were admitted solely for management of hypoglycaemia. Further research should determine whether maternal antihypertensive agent choice or postnatal pathways may reduce NNU admission.
量化患有妊娠高血压疾病（HDP）的晚期早产儿和足月儿在新生儿重症监护病房（NNU）的入院率，并评估避免入院的机会。
使用全国新生儿研究数据库进行的回顾性基于人群的研究。
英格兰和威尔士。
2012 年至 2020 年期间出生于≥34 周胎龄并入住 NNU 的婴儿。
使用回归模型比较 HDP 婴儿和非 HDP 婴儿的结局。
妊娠高血压疾病、入院的主要原因、临床诊断和资源利用。
16059/136220（11.8%）例晚期早产儿（34-36 周）和 14885/284646（5.2%）例足月儿（≥37 周）的母亲患有 HDP。HDP 婴儿入院的主要原因是呼吸疾病（28.3%）、早产（22.7%）和低血糖（16.4%）。与非 HDP 婴儿相比，HDP 婴儿更有可能因原发性低血糖而入院（比值比[OR]2.1，95%置信区间[CI]2.0-2.2，P<0.0001）。64.5%的 HDP 婴儿接受静脉葡萄糖治疗。35.7%的婴儿接受机械通气或非侵入性通气。8260/30944（26.7%）例 HDP 婴儿仅因低血糖（静脉葡萄糖）接受干预，无其他主要干预（呼吸支持、肠外营养、中心静脉导管、动脉导管或输血）。
患有妊娠高血压疾病的母亲对晚期早产儿和足月儿入住 NNU 的负担很大，低血糖和呼吸疾病是入院的主要原因。超过四分之一的婴儿仅因低血糖而入院。进一步的研究应确定母体降压药物的选择或产后途径是否可以减少 NNU 的入院率。
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