Evaluation of Laboratory Disorders in Admitted Neonates in NICU Who Were Born to Preeclamptic Mothers

Abstract

Background: Preeclampsia is a major cause of maternal, fetal and neonatal morbidity and mortality. Objectives: The aim of this study was to determine the laboratory disorders in neonates born to preeclamptic mothers. Patients and Methods: This descriptive-retrospective study was conducted in the neonatal units of Shahid Beheshti and Shabihkhani Hospitals on neonates born to preeclamptic mothers during 2009 -2012. Neonatal data including gestational age, gender, mode of delivery, birth weight and laboratory reports were extracted from their medical records and analyzed. Results: A total of 2600 newborns were admitted during the study period, of which 84 infants were born to mothers with preeclampsia. The laboratory disorders were neutropenia in 32 cases (37%), anemia in 33 (39.2%), leucopenia in 24 (28.5%), thrombocytopenia in 23 (27.3%), hypoglycemia in 28 (33.3%), hypocalcemia in 22 (26.1%) and hyperbilirubinemia in 33 (39.2%) patients. Thirty one infants (35.6%) had positive cultures .Twenty nine patients (35%) developed coagulative disorders with prolonged PT and PTT. Evaluation of ABG showed 16 infants (19%) with metabolic acidosis, 23 (27.3%) hypoxia and 24 (28.5%) respiratory acidosis cases. All the laboratory abnormalities were more common in preterm and low birth-weight-infants. Conclusions: Early detection and timely management of laboratory disorders in preeclamptic infants may lead to improvement of the neonatal outcomes.

Study of changes noted in the platelet count in cord blood of neonates born to hypertensive mothers in a tertiary care hospital, Bangalore, India

“…[27][28][29][30] Platelet counts were more affected in neonates of eclamptic and pre-eclampsia mothers than in mothers with gestational hypertension, suggesting that the severity as well as the duration of hypertension is important in influencing the platelets of neonates born to HDP mothers and eventually the final neonatal and perinatal outcome. 23,24 This result is similar to a study done by Bhat and Cherian (2008) who reported that in neonates of mothers with preeclampsia, the percentage of neonatal thrombocytopenia was 36% and it is more likely to occur in preterm and low birth weight infants. 25 Increased risk of sepsis was found in cases and in the neonates with neutropenia.…”

Study of Changes in Haemoglobin Level and Leukocyte Counts in Cord Blood of Newborns of Hypertensive Mothers in Agmc and Gb Pant Hospital

“…Similar studies conducted by Prakash PL et al [4] found leukopenia in 63.9%, 45.3% and 39.3% babies of preeclamptic, eclamptic and gestational hypertension mothers respectively and 28.5% by Mosayebi Z et al [13] Neutropenia was found in 3.3% of newborns of hypertensive mothers. Other studies also found neutropenia in newborns of hypertensive mothers as 58.1% by Bolat A et al, [3] 17.9%, 30.6% and 27.5% babies of preeclamptic, eclamptic and gestational hypertension mothers respectively by Prakash PL et al [4] and 37% of babies of pre-eclamptic mothers by Mosayebi Z et al [13] Lymphopenia was found in 13.3% in newborns of hypertensive mothers in this study and 35.5% in study by Bolat A et al [3] No polycthaemia were found in the newborns of hypertensive mothers as compared to 8.2% by Onyiruika AN et al [7] Anaemia was found in 23.3% of newborns born of hypertensive mothers as compared to 39.2% by Mosayebi Z et al [13] The increase in haemoglobin level in the study group can be due to the hypoxia leading to uteroplacental insufficiency resulting in increase in erythropoiesis. This is supported by the works of Bolat A et al and Sivkumar et al, but is contradictory to the work of Prakash PL et al But anemia was documented in 23.4% of infants of hypertensive mothers in this study which was found to be similar to those of Mosayebi Z et al and Prakash PL et al This may be due to a number of reasons-it can be due to ineffective erythropoiesis among the infants of hypertensive mothers because of inhibitory factors produced due to hypertensive disorders.…”

“…[6] Neutropenia is well documented in this group. [3,4,10,11,12,7] This can be associated with infection and sepsis. [3,10,12] Studies show multiple mechanisms leading to decrease in neutrophil count.…”

A Case-Control Study About Hematological Profile and Morbidity of Newborns at Birth, Born to Mothers With Hypertension in Pregnancy.

“…Tsoa et al 15 observed that C-reactive protein (CRP) was detecting inflammation, which was significantly increased in infant of preeclamptic mother. Mosayeb et al 16 had also found sepsis about that, Positive cultures including blood, urine and CSF were observed in 16.6%, 11.9% and 7.1% of infants respectively. They were almost all preterm neonates.…”