Eva Morsing1, Karel Maršál2, David Ley1. 1. Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden. 2. Department of Obstetrics and Gynecology, Clinical Sciences Lund, Lund University, Lund, Sweden.
Abstract
BACKGROUND: Very preterm (VPT) delivery after severe preeclampsia (PE) has been associated with adverse perinatal outcome. It is unclear whether fetal exposure to PE per se modifies the prevalence of neonatal morbidities associated with VPT birth. OBJECTIVES: To evaluate neonatal morbidity in VPT infants exposed to maternal PE compared to morbidity in nonexposed VPT infants. METHODS: This retrospective study consisted of all inborn infants delivered before 30 gestational weeks admitted to a tertiary-level neonatal intensive care unit between 1998 and 2014: 195 infants exposed to maternal PE were compared to 957 infants without maternal PE (background group). Prevalence rates of neonatal morbidity, cerebral palsy (CP), and mortality at 2 years of age were obtained from patient records. RESULTS: The PE group had a lower median (IQR) birth weight (795 [262] g) and a higher median gestational age (GA) (27 [3] weeks) at birth than the background group (890 [385] g and 26 [3] weeks, respectively; both p < 0.001). Exposure to maternal PE was associated with lower rates of severe intraventricular hemorrhage (IVH) (2 vs. 11%), retinopathy of prematurity requiring treatment (2 vs. 7%), mortality (9 vs. 15%), and CP (4 vs. 8%). Exposure to PE remained associated with a reduced prevalence of severe IVH (OR 0.17, 95% CI 0.05-0.57) after adjustment for GA, multiple birth, Apgar score, delivery mode, sex, and antenatal steroid treatment. CONCLUSION: Fetal exposure to PE is associated with a decreased rate of severe IVH following VPT birth. Studies on underlying mechanisms may provide a basis for prevention of IVH in the VPT infant.
BACKGROUND: Very preterm (VPT) delivery after severe preeclampsia (PE) has been associated with adverse perinatal outcome. It is unclear whether fetal exposure to PE per se modifies the prevalence of neonatal morbidities associated with VPT birth. OBJECTIVES: To evaluate neonatal morbidity in VPT infants exposed to maternal PE compared to morbidity in nonexposed VPT infants. METHODS: This retrospective study consisted of all inborninfants delivered before 30 gestational weeks admitted to a tertiary-level neonatal intensive care unit between 1998 and 2014: 195 infants exposed to maternal PE were compared to 957 infants without maternal PE (background group). Prevalence rates of neonatal morbidity, cerebral palsy (CP), and mortality at 2 years of age were obtained from patient records. RESULTS: The PE group had a lower median (IQR) birth weight (795 [262] g) and a higher median gestational age (GA) (27 [3] weeks) at birth than the background group (890 [385] g and 26 [3] weeks, respectively; both p < 0.001). Exposure to maternal PE was associated with lower rates of severe intraventricular hemorrhage (IVH) (2 vs. 11%), retinopathy of prematurity requiring treatment (2 vs. 7%), mortality (9 vs. 15%), and CP (4 vs. 8%). Exposure to PE remained associated with a reduced prevalence of severe IVH (OR 0.17, 95% CI 0.05-0.57) after adjustment for GA, multiple birth, Apgar score, delivery mode, sex, and antenatal steroid treatment. CONCLUSION: Fetal exposure to PE is associated with a decreased rate of severe IVH following VPT birth. Studies on underlying mechanisms may provide a basis for prevention of IVH in the VPT infant.
Authors: Leah A Owen; Kinsey Shirer; Samuel A Collazo; Kathryn Szczotka; Shawna Baker; Blair Wood; Lara Carroll; Benjamin Haaland; Takeshi Iwata; Lakshmi D Katikaneni; Margaret M DeAngelis Journal: Front Mol Neurosci Date: 2020-11-17 Impact factor: 5.639
Authors: Zoe A Broere-Brown; Maria C Adank; Laura Benschop; Myrte Tielemans; Taulant Muka; Romy Gonçalves; Wichor M Bramer; Josje D Schoufour; Trudy Voortman; Eric A P Steegers; Oscar H Franco; Sarah Schalekamp-Timmermans Journal: Biol Sex Differ Date: 2020-05-11 Impact factor: 5.027