Hypertension induced by pregnancy and neonatal outcome: Results from a retrospective cohort study in preterm under 34 weeks

Abstract

Objective The present study seeks to assess the impact of gestational hypertensive disorders on premature newborns below 34 weeks and to establish the main morbidities and mortality in the neonatal period and at 18 months. Materials and methods A retrospective observational study was carried out with 695 premature newborns of gestational age (GA) between 24 and 33 weeks and 6 days, born alive in the Neonatal ICU of Brasília’s Mother and Child Hospital (HMIB), in the period from January 1, 2014, to July 31, 2019. In total, 308 infants were born to hypertensive mothers (G1) and 387 to normotensive mothers (G2). Twin pregnancies and diabetic patients with severe malformations were excluded. Outcomes during hospitalization and outcomes of interest were evaluated: respiratory distress syndrome (RDS), brain ultrasonography, diagnosis of bronchopulmonary dysplasia (BPD), diagnosis of necrotizing enterocolitis, retinopathy of prematurity, breastfeeding rate at discharge, survival at discharge and at 18 months of chronological age and relationship between weight and gestational age. Results Newborns with hypertensive mothers had significantly lower measurements of birth weight and head circumference. The G1 group had a higher risk small for gestational age (OR 2.4; CI 95% 1.6–3.6; p <0.00), as well as a greater risk of being born with a weight less than 850 g (OR 2.4; 95% CI 1.2–3.5; p <0.00). Newborns of mothers with hypertension presented more necrotizing enterocolitis (OR 2.0; CI 95% 1.1–3.7); however, resuscitation in the delivery room and the need to use surfactant did not differ between groups, nor did the length of stay on mechanical ventilation, or dependence on oxygen at 36 weeks of gestational age. Survival was better in newborns of normotensive mothers, and this was a protective factor against death (OR 0.7; 95% CI 0.5–0.9; p <0.01). In the follow-up clinic, survival at 18 months of chronological age was similar between groups, with rates of 95.3% and 92.1% among hypertensive and normotensive mothers, respectively. Exclusive breastfeeding at discharge was 73.4% in the group of hypertensive women and 77.3% in the group of normotensive mothers. There were no significant differences between groups. Conclusion Among the analyzed outcomes, arterial hypertension during pregnancy can increase the risk of low weight, small babies for gestational age (SGA), deaths in the neonatal period and enterocolitis, with no differences in weight and survival at 18 months of chronological age. Arterial hypertension presents a high risk of prematurity in the neonatal period, with no difference at 18 months of age.

Simplified lung ultrasound method to predict the respiratory support needs of neonates whose mothers had pregnancy complications: a diagnostic accuracy study

“…Neonates whose mothers had GDM and preeclampsia were more likely to develop respiratory disorders. Although this view has been widely accepted in several studies [4,[20][21][22] , an increasing number of opposing opinions have been proposed [23][24][25][26] . MH has received little attention for neonatal respiratory issues because it mainly affects the nervous system.…”

Risk factors of extrauterine growth restriction in very preterm infants with bronchopulmonary dysplasia: a multi-center study in China

“…Previous studies have reported that the percentile on the Fenton curve at birth is an important predictor of EUGR [23]. In addition, gestational hypertension can increase the need for emergency cesarean section [24], which is an independent risk factor for low Apgar score [25]. These infants are often born sick and even require mechanical ventilation, leading to an increased risk of BPD and EUGR.…”

Earthing Method as Lifestyle Medicine to Reduce Hypertension in Pregnancy in Surakarta City, Central Java, IndonesiaEarthing Method as Lifestyle Medicine to Reduce Hypertension in Pregnancy

“…The first experiment was with grounding without tools, where the researcher's feet directly touched the ground/grass [4]. Figure 2 is leg-wearing rubber footwear (not grounding); the skin voltage reaches 274.8 millivolts.…”

“…The incidence of hypertension in pregnancy in Indonesia is 24% the cause of maternal death (1) and is a significant cause of morbidity and mortality of mothers and infants worldwide (2). Hypertension in pregnancy leads to preeclampsia and eclampsia (seizures) (3); it is also the highest cause of neonatal death, namely the leading cause of low birth weight (4,5). Research reports that Earthing can reduce hypertension by reducing blood viscosity (6), a major factor in cardiovascular disease (7,8).…”