Li Qingxuan, Wu Tian, Mao Yanxia, Yang Yi, Mu Yi, Tang Jun, Xiong Tao
Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section Three, South Renmin Road, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
BMC Pregnancy Childbirth. 2025 Jun 7;25(1):668. doi: 10.1186/s12884-025-07778-8.
Hypertensive disorders in pregnancy (HDP), including four subtypes, are common complications significantly contributing to perinatal morbidity and mortality. Research on the impact of HDP subtypes-preeclampsia/eclampsia (PE/E) and superimposed preeclampsia (SP)-on comprehensive outcomes for hospitalized neonates is relatively limited. Additionally, PE/E and SP often result in shorter gestational age (GA), and the role of GA in the preterm birth-related complications of these HDP subtypes remains unclear.
This retrospective cohort study identified a total of 989 cases (exposed group), including 845 cases of PE/E and 144 cases of SP . We randomly selected 989 normotensive pregnant women from the same period as controls (control group). Adjusted odds ratios and 95% confidence intervals for neonatal outcomes were calculated using logistic regression. Mediation analysis was conducted to investigate the role of GA in the relationship between HDP subtypes and preterm birth-related complications.
Both PE/E and SP increased the risk of adverse birth outcomes, including preterm birth, small for gestational age, low birth weight, and asphyxia, as well as hematological complications such as neutropenia, polycythemia, and thrombocytopenia. PE/E and SP also increased the risk of hypoglycemia while decreasing the risk of pathologic jaundice, with no impact on infection complications. Mediation analysis revealed that PE/E increased the risk of intraventricular hemorrhage while reducing the risk of patent ductus arteriosus and retinopathy of prematurity, both through direct effects (the disease of PE/E itself) and indirect effects (via GA). SP increased the risk of neonatal respiratory distress syndrome and intraventricular hemorrhage through indirect effects (via GA).
PE/E and SP are key maternal diseases influencing the outcomes of hospitalized neonates, with GA playing an important mediating role in preterm birth-related complications. Early monitoring and management of those mothers and infants are crucial to improving prognosis.
妊娠期高血压疾病（HDP）包括四种亚型，是导致围产期发病和死亡的常见并发症。关于HDP亚型——子痫前期/子痫（PE/E）和叠加子痫前期（SP）——对住院新生儿综合结局影响的研究相对有限。此外，PE/E和SP常导致孕周缩短，而孕周在这些HDP亚型与早产相关并发症中的作用仍不清楚。
这项回顾性队列研究共纳入989例病例（暴露组），包括845例PE/E和144例SP。我们从同一时期随机选取989例血压正常的孕妇作为对照（对照组）。采用逻辑回归计算新生儿结局的调整比值比和95%置信区间。进行中介分析以研究孕周在HDP亚型与早产相关并发症关系中的作用。
PE/E和SP均增加了不良出生结局的风险，包括早产、小于胎龄儿、低出生体重和窒息，以及血液学并发症如中性粒细胞减少、红细胞增多症和血小板减少。PE/E和SP还增加了低血糖风险，同时降低了病理性黄疸风险，对感染并发症无影响。中介分析显示，PE/E通过直接效应（PE/E本身的疾病）和间接效应（通过孕周）增加了脑室内出血风险，同时降低了动脉导管未闭和早产儿视网膜病变的风险。SP通过间接效应（通过孕周）增加了新生儿呼吸窘迫综合征和脑室内出血的风险。
PE/E和SP是影响住院新生儿结局的关键母体疾病，孕周在早产相关并发症中起重要中介作用。对这些母婴进行早期监测和管理对改善预后至关重要。
