Maternal preeclampsia and respiratory outcomes in extremely premature infants

Tagliaferro, Thea; Jain, Deepak; Vanbuskirk, Silvia; Bancalari, Eduardo; Claure, Nelson

doi:10.1038/s41390-019-0336-5

Cited by 30 publications

(40 citation statements)

References 18 publications

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“…In a large national cohort study conducted in the United States, which included 156,681 infants born to mothers with preeclampsia, the greater probability of RDS was found in the preeclamptic group compared to the non-preeclamptic group (6.6% vs. 1.9%) 17 . Another recent single-center cohort study including infants born at 23–28 gestational weeks also revealed that preeclampsia increased the risk of severe RDS 18 . Preeclampsia is characterized by an imbalanced maternal angiogenic state, resulting in generalized endothelial dysfunction, increased levels of maternal antiangiogenic factor soluble fms-like tyrosine kinase-1 (sFlt-1), and decreased free circulating levels of the angiogenic factors vascular endothelial growth factor (VEGF) and placental growth factor 20–23 .…”

Section: Discussionmentioning

confidence: 94%

“…In contrast, Tagliaferro et al . 18 found in a cohort study that the risk of severe RDS was increased in extremely premature (23–28 gestational weeks) infants exposed to preeclampsia. Thus, this study aimed to analyze the relationship between maternal preeclampsia and the development of RDS in very-low-birth-weight (VLBW) infants in a large cohort.…”

Section: Introductionmentioning

confidence: 98%

“…Preterm RDS is secondary to surfactant insufficiency, and its incidence is usually related inversely to gestational age (GA). The literature contains conflicting information on the effect of preeclampsia per se on RDS 6–18 . Shah et al .…”

Section: Introductionmentioning

confidence: 99%

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Association of Maternal Preeclampsia with Neonatal Respiratory Distress Syndrome in Very-Low-Birth-Weight Infants

Wen

Yang

Chou

et al. 2019

Sci Rep

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Preeclampsia is a common cause of preterm birth and neonatal morbidity, but its relationship with neonatal respiratory distress syndrome (RDS) remains controversial. We conducted a retrospective cohort study with data from very-low-birth-weight (VLBW) infants born in 1997–2014 from the database of the Premature Baby Foundation of Taiwan to evaluate the relationship between maternal preeclampsia and neonatal RDS. In total, 13,490 VLBW infants were enrolled, including 2200 (16.3%) infants born to preeclamptic mothers. The mean (standard deviation) gestational ages were 30.7 (2.5) weeks in the preeclamptic group and 28.6 (2.9) weeks in the control (non-preeclamptic) group. Severe RDS was defined according to the surfactant therapy requirement. The incidence of severe RDS was lower in infants exposed to maternal preeclampsia than in controls [28.9% vs. 44%; odds ratio (OR), 0.52; 95% confidence interval (CI), 0.47–0.57]. However, after adjustment for confounders, the OR for severe RDS development in the preeclampsia group was 1.16 (95% CI, 1.02–1.31). Other factors, such as gestational age, birth weight, female sex, and antenatal receipt of two or more steroid doses were significantly protective against RDS in multivariate regression analysis. This study revealed that maternal preeclampsia slightly increases the risk of severe RDS in VLBW infants.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Association of Maternal Preeclampsia with Neonatal Respiratory Distress Syndrome in Very-Low-Birth-Weight Infants

Wen

Yang

Chou

et al. 2019

Sci Rep

View full text Add to dashboard Cite

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“…Gestational diabetes mellitus (GDM) was defined according to blood glucose level with a 75 g oral glucose tolerance test (OGTT): fasting ≥ 5.3 mmol/L, 1 hour ≥ 10.6 mmol/L, or 2 hours ≥ 9.0 mmol/L [13]. Gestational hypertension was defined as a systolic blood pressure of ≥140 mmHg or diastolic blood pressure of ≥90 mmHg after 20 weeks of gestation [14]. Neonatal respiratory distress syndrome (NRDS) was diagnosed according to the clinical symptoms and chest X-ray.…”

Section: Methodsmentioning

confidence: 99%

The Utility of Comprehensive Metabolic Panel Tests for the Prediction of Bronchopulmonary Dysplasia in Extremely Premature Infants

et al. 2019

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Background Comprehensive metabolic panel tests (CMP) are routinely performed in extremely premature infants within the first days of life. The association between the parameters of first postnatal CMP and the risk of bronchopulmonary dysplasia (BPD) remains elusive. Methods A retrospective analysis was performed to evaluate the correlation between the parameters of first postnatal CMP and the risk of BPD in a cohort of extremely premature infants (born with a gestational age less than 28 weeks or a birth weight less than 1000 grams) at the neonatal intensive care unit, Shenzhen Maternity and Child Healthcare Hospital, from January 2016 to October 2018. A multivariant regression model was built to assess the association of the first postnatal CMP with the development of BPD. Results A total of 256 extremely premature infants were included in this study. BPD developed in 76 (29.7%) infants. The first CMP in these infants was performed at 5 to 8 days after birth. The levels of blood urea nitrogen (BUN) and magnesium were significantly higher in infants with BPD compared to infants with no BPD (10.2 versus 7.5 mmol/L, P < 0.001 and 0.9 versus 0.8 U/L, P = 0.001, respectively) whereas the level of alkaline phosphatase (ALP) and total protein was significantly lower in infants with BPD (215.5 versus 310.0 U/L, P = 0.002 and 41.2 versus 42.9 g/L, P = 0.037, respectively). Multiple analysis showed that a higher level of BUN (>8.18 mmol/L) was independently associated with BPD (OR 3.261, 95% CI 1.779-5.978). Conclusion Our findings indicate that a higher postnatal BUN level (>8.18 mmol/L) may be a predictor for the development of BPD in extremely premature infants.

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“…Both premature and late delivery can significantly increase the health risks of newborns 1–3 and respiratory complications are very common in very premature infants 4 . Bronchopulmonary dysplasia (BPD), as the main chronic respiratory system disease, is seriously affecting preterm infants 5–8 .…”

Section: Introductionmentioning

confidence: 99%

Comparisons of two definitions of bronchopulmonary dysplasia for the premature infants

2021

Pediatric Pulmonology

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Objective Bronchopulmonary dysplasia (BPD) is a very common respiratory disease in premature infants, but there is still a different understanding of the definition of BPD. Therefore, this study is intended to compare are main clinical results and health economic expenditures under different BPD definitions. Methods This study included premature infants who came into the neonatal intensive care unit (NICU) from January 2018 to January 2020, who were not more than 32 weeks of premenstrual age. The main clinical consequences and health economic expenditures were analyzed by the National Institute of Health and Human Development definition (Workshop) and Jensen definition. Results Total 303 survivors were evaluated at 36 weeks. BPD was performed in 47.5% and 37.6% of infants, respectively, with Workshop's and Jensen's definitions. The percentage of unclassified BPD infants was 0.9% in Workshop's and 3.3% in Jensen's definitions. Further discussing the health economic burden and found that Jensen's definitions had a significantly correlated with NICU charges than the Workshop's definitions. Conclusion Comparing the Workshop definition of BPD, the Jensens definition was better correlated to health expenditure.

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Maternal preeclampsia and respiratory outcomes in extremely premature infants

Cited by 30 publications

References 18 publications

Association of Maternal Preeclampsia with Neonatal Respiratory Distress Syndrome in Very-Low-Birth-Weight Infants

Association of Maternal Preeclampsia with Neonatal Respiratory Distress Syndrome in Very-Low-Birth-Weight Infants

The Utility of Comprehensive Metabolic Panel Tests for the Prediction of Bronchopulmonary Dysplasia in Extremely Premature Infants

Comparisons of two definitions of bronchopulmonary dysplasia for the premature infants

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