A Retrospective Cohort Study on Mortality and Neurodevelopmental Outcomes of Preterm Very Low Birth Weight Infants Born to Mothers with Hypertensive Disorders of Pregnancy

Yumi Kono; Naohiro Yonemoto; Hidehiko Nakanishi; Shigeharu Hosono; Shinya Hirano; Satoshi Kusuda; Masanori Fujimura; for the Neonatal Research Network Japan

doi:10.1055/s-0041-1722874

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2022; 39(13): 1465-1477
DOI: 10.1055/s-0041-1722874

Original Article

A Retrospective Cohort Study on Mortality and Neurodevelopmental Outcomes of Preterm Very Low Birth Weight Infants Born to Mothers with Hypertensive Disorders of Pregnancy

Yumi Kono

¹Department of Pediatrics, Jichi Medical University, Shimotsuke, Tochigi, Japan

,

Naohiro Yonemoto

²Department of Psychoneuropharmacology, National institute of Mental Health, National Center of Neurology and Psychiatry, Kodira, Tokyo, Japan

,

Hidehiko Nakanishi

³Division of Neonatal Intensive Care Medicine, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan

,

Shigeharu Hosono

⁴Department of Perinatal and Neonatal Medicine, Jichi Medical University Saitama Medical Center, Saitama, Saitama, Japan

,

Shinya Hirano

⁵Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan

,

Satoshi Kusuda

⁶Department of Pediatrics, Kyorin University, Mitaka, Tokyo, Japan

,

Masanori Fujimura

⁵Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan

,

for the Neonatal Research Network Japan

› Institutsangaben

Abstract

Objective We examined the effects of maternal hypertensive disorders of pregnancy (HDP) on the mortality and neurodevelopmental outcomes in preterm very low birth weight (VLBW) infants (BW ≤1,500 g) based on their intrauterine growth status and gestational age (GA).

Study Design We included singleton VLBW infants born at <32 weeks' gestation registered in the Neonatal Research Network Japan database. The composite outcomes including death, cerebral palsy (CP), and developmental delay (DD) at 3 years of age were retrospectively compared among three groups: appropriate for GA (AGA) infants of mothers with and without HDP (H-AGA and N-AGA) and small for GA (SGA) infants of mothers with HDP (H-SGA). The adjusted odds ratios (AOR) and 95% confidence intervals (CI) stratified by the groups of every two gestational weeks were calculated after adjusting for the center, year of birth, sex, maternal age, maternal diabetes, antenatal steroid use, clinical chorioamnionitis, premature rupture of membranes, non-life-threatening congenital anomalies, and GA.

Results Of 19,323 eligible infants, outcomes were evaluated in 10,192 infants: 683 were H-AGA, 1,719 were H-SGA, and 7,790 were N-AGA. Between H-AGA and N-AGA, no significant difference was observed in the risk for death, CP, or DD in any GA groups. H-AGA had a lower risk for death, CP, or DD than H-SGA in the 24 to 25 weeks group (AOR: 0.434, 95% CI: 0.202–0.930). The odds for death, CP, or DD of H-SGA against N-AGA were found to be higher in the 24 to 25 weeks (AOR: 2.558, 95% CI: 1.558–3.272) and 26 to 27 weeks (AOR: 1.898, 95% CI: 1.427–2.526) groups, but lower in the 30 to 31 weeks group (AOR: 0.518, 95% CI: 0.335–0.800).

Conclusion There was a lack of follow-up data; however, the outcomes of liveborn preterm VLBW infants of mothers with HDP depended on their intrauterine growth status and GA at birth.

Key Points

The effects of HDP on preterm low birth weight infants need to be further examined.
The outcomes were not different between AGA infants with and without maternal HDP.
The outcomes of SGA infants with maternal HDP were dependent on their GA.

Keywords

hypertensive disorders of pregnancy - preterm - small for gestational age - appropriate for gestational age - mortality - cerebral palsy - development

Volltext

Referenzen

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