Effects of hypertensive disorders of pregnancy on the complications in very low birth weight neonates

ABSTRACT

Objective

This study was designed to investigate the effects of hypertensive disorders of pregnancy (HDP) on the complications in very low birth weight (VLBW) neonates.

Methods

We retrospectively included VLBW neonates (<37 weeks) who were delivered by HDP pregnant women with a body weight of < 1,500 g (HDP group) hospitalized in our hospital between January 2016 and July 2021. Gestational age matched VLBW neonates delivered by pregnant women with a normal blood pressure, with a proportion of 1:1 to the HDP group in number, served as normal control.

Results

Then we compared the peripartum data and major complications between HDP group and control. The body weight, prelabor rupture of membrane (PROM), maternal age, cesarean section rate, fetal distress, small for gestational age (SGA), mechanical ventilation, RDS, necrotizing enterocolitis (NEC) (≥2 stage), Apgar score at 1 min, and mortality in HDP group showed statistical differences compared with those of the control (all p < 0.05). To compare the major complications among HDP subgroups, we classified the VLBW neonates of the HDP group into three subgroups including gestational hypertension group (n = 72), pre-eclampsia (PE) group (n = 222), and eclampsia group (n = 14), which showed significant differences in the fetal distress, Apgar score at 1 min, SGA, ventilation, RDS and NEC (≥2 stage) among these subgroups (all p < 0.05). Multivariate regression analysis showed that eclampsia and PE were the independent risk factors for SGA and NEC, respectively.

Conclusion

HDP was associated with increased incidence of neonatal asphyxia, fatal distress, SGA, mechanical ventilation, RDS, NEC and mortality. Besides, eclampsia and PE were independent risk factors for SGA and NEC.

KEYWORDS:

• Hypertensive disorders of pregnancy
• hypertension
• pre-eclampsia
• eclampsia
• very low birth weight neonate

Disclosure statement

No potential conflict of interest was reported by the author(s).

Article Highlights

• Effects of HDP on VLBW neonates.

• Eclampsia was a risk factor for SGA and NEC.

• PE was a risk factor for SGA and NEC.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Author contribution

ZBQ and YCY contributed to conception and design of the study. CXJ, SHY and XWL organized the database. ZBQ performed the statistical analysis. ZBQ and CXJ wrote the first draft of the manuscript. YCY, SHY and XWL wrote sections of the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version.

Additional information

Funding

This study was supported by the Young Talent Program of Fujian Health Bureau [No. 2019-1-16, granted to Baoquan Zhang], and Sailing Project of Fujian Medical University [No. 2020QH1194, granted to Baoquan Zhang], and the Social Developmental Induction Program of Fujian Province [No. 2019Y0058, granted to Changyi Yang].