Neonatology Department, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
Hypertens Pregnancy. 2024 Dec;43(1):2314576. doi: 10.1080/10641955.2024.2314576. Epub 2024 Feb 20.
This study was designed to investigate the effects of hypertensive disorders of pregnancy (HDP) on the complications in very low birth weight (VLBW) neonates.
We retrospectively included VLBW neonates (<37 weeks) who were delivered by HDP pregnant women with a body weight of < 1,500 g (HDP group) hospitalized in our hospital between January 2016 and July 2021. Gestational age matched VLBW neonates delivered by pregnant women with a normal blood pressure, with a proportion of 1:1 to the HDP group in number, served as normal control.
Then we compared the peripartum data and major complications between HDP group and control. The body weight, prelabor rupture of membrane (PROM), maternal age, cesarean section rate, fetal distress, small for gestational age (SGA), mechanical ventilation, RDS, necrotizing enterocolitis (NEC) (≥2 stage), Apgar score at 1 min, and mortality in HDP group showed statistical differences compared with those of the control (all < 0.05). To compare the major complications among HDP subgroups, we classified the VLBW neonates of the HDP group into three subgroups including gestational hypertension group ( = 72), pre-eclampsia (PE) group ( = 222), and eclampsia group ( = 14), which showed significant differences in the fetal distress, Apgar score at 1 min, SGA, ventilation, RDS and NEC (≥2 stage) among these subgroups (all < 0.05). Multivariate regression analysis showed that eclampsia and PE were the independent risk factors for SGA and NEC, respectively.
HDP was associated with increased incidence of neonatal asphyxia, fatal distress, SGA, mechanical ventilation, RDS, NEC and mortality. Besides, eclampsia and PE were independent risk factors for SGA and NEC.
本研究旨在探讨妊娠高血压疾病（HDP）对极低出生体重（VLBW）新生儿并发症的影响。
我们回顾性纳入了 2016 年 1 月至 2021 年 7 月在我院住院分娩且母亲患有 HDP（体重<1500g）的 VLBW 新生儿（<37 周）。按照 1:1 比例匹配同期母亲血压正常、体重<1500g 的 VLBW 新生儿作为正常对照组。
比较 HDP 组与对照组的围生期资料和主要并发症。HDP 组的体重、胎膜早破（PROM）、产妇年龄、剖宫产率、胎儿窘迫、小于胎龄儿（SGA）、机械通气、呼吸窘迫综合征（RDS）、坏死性小肠结肠炎（NEC）（≥2 期）、1 分钟 Apgar 评分和死亡率与对照组相比差异有统计学意义（均 P<0.05）。为比较 HDP 亚组的主要并发症，我们将 HDP 组的 VLBW 新生儿分为妊娠期高血压组（ = 72）、子痫前期（PE）组（ = 222）和子痫组（ = 14），这三组在胎儿窘迫、1 分钟 Apgar 评分、SGA、机械通气、RDS 和 NEC（≥2 期）等方面存在显著差异（均 P<0.05）。多因素回归分析显示，子痫和 PE 是 SGA 和 NEC 的独立危险因素。
HDP 与新生儿窒息、严重胎儿窘迫、SGA、机械通气、RDS、NEC 和死亡率增加有关。此外，子痫和 PE 是 SGA 和 NEC 的独立危险因素。
