Correlation between hypertensive retinopathy and fetal outcomes in patients with preeclampsia in a tertiary care hospital: A prospective cohort study

Abstract

Purpose: To study the effect of increasing grades of hypertensive retinopathy (HTR) on neonatal outcomes among preeclamptic women and assess the various maternal risk factors for HTR. Methods: A prospective cohort study was conducted on 258 preeclamptic women. The systolic and diastolic blood pressure (SBP and DBP), liver, and renal function parameters were collected besides basic demographic details. Dilated fundus examination with the Keith–Wagner–Barker classification was used to grade HTR. Following delivery, neonatal outcomes were evaluated. Results: Of the 258 preeclamptic women recruited, 53.1% had preeclampsia (PE), and 46.9% had severe preeclampsia. With increasing grades of HTR, a significant association with low birth weight (LBW) ( p = 0.012) and preterm gestational age ( p = 0.002) was noted but not with the Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score ( p = 0.062). Also, it did not increase the risk of retinopathy of prematurity (ROP), with most babies, even those born to mothers with high grades of HTR, showing no evidence of ROP ( p = 0.025). Among the maternal factors, increasing age ( p = 0.016), SBP ( p < 0.001), DBP ( p < 0.001), serum creatinine ( p = 0.035), alanine aminotransferase ( p = 0.008), lower hemoglobin (Hb) ( p = 0.009), lower platelet ( p < 0.001), and severe PE ( p < 0.001) have been found to significantly affect the grade of HTR. Conclusion: Higher grades of HTR in the preeclamptic mother are associated with preterm delivery and LBW of the neonates but neither affect the APGAR score nor pose the risk of developing ROP.