Impact of hypertensive disorder complicating pregnancy on neonatal mortality and major complications in preterm infants

Meiyu Wang; Xiangyong Kong; Zhichun Feng; Fengdan XU; Hongyan Lyu; Lihong Yang; Sujing WU; Rong JU; Jin Wang; Li Peng; Zhankui LI; Xiaolin Zhao; Shujuan Zeng; Huixian Qiu; Weixi Wen; Hui WU; Ying LI; Nan LI; Xuefeng Zhang; Wenzheng Jia; Guo Guo; Weipeng Liu; Feng Wang; Gaimei LI; Fang Liu; Wei LI; Xiao-ying Zhao; Hongbin Cheng; Yunbo XU; Wenchao Chen; Huan Yin; Yanjie Ding; Xiaoliang Wang; Ruiyan Shan; Ping XU; Meiying Han; Chunyan Yang; Tieqiang Chen; Xiaomei Tong; Shaojun Liu; Ziyuan Liu

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Impact of hypertensive disorder complicating pregnancy on neonatal mortality and major complications in preterm infants

VernacularTitle: 母亲妊娠期高血压疾病对早产儿病死率及主要并发症的影响
Author: Meiyu WANG ^{1
,

2} ; Xiangyong KONG ^{1
,

2} ; Zhichun FENG ^{1
,

2} ; Fengdan XU ³ ; Hongyan LYU ⁴ ; Lihong YANG ⁴ ; Sujing WU ⁴ ; Rong JU ⁵ ; Jin WANG ⁵ ; Li PENG ⁵ ; Zhankui LI ⁶ ; Xiaolin ZHAO ⁶ ; Shujuan ZENG ⁷ ; Huixian QIU ⁷ ; Weixi WEN ⁷ ; Hui WU ⁸ ; Ying LI ⁸ ; Nan LI ⁸ ; Xuefeng ZHANG ⁹ ; Wenzheng JIA ⁹ ; Guo GUO ⁹ ; Weipeng LIU ¹⁰ ; Feng WANG ¹⁰ ; Gaimei LI ¹⁰ ; Fang LIU ¹¹ ; Wei LI ¹¹ ; Xiao-ying ZHAO ¹¹ ; Hongbin CHENG ¹² ; Yunbo XU ¹² ; Wenchao CHEN ¹² ; Huan YIN ¹² ; Yanjie DING ¹³ ; Xiaoliang WANG ¹³ ; Ruiyan SHAN ¹³ ; Ping XU ¹⁴ ; Meiying HAN ¹⁴ ; Chunyan YANG ¹⁴ ; Tieqiang CHEN ¹⁵ ; Xiaomei TONG ¹⁶ ; Shaojun LIU ¹⁶ ; Ziyuan LIU ¹⁶
Author Information

1. Army General Hospital Affiliated to Southern Medical University, Guangzhou 510515, China
2. Neonatal Intensive Care Unit, Affiliated Bayi Children′s Hospital, People′s Liberation Army General Hospital, National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing Key Laboratory of Pediatric Organ Failure, Beijing 100700, China
3. Department of Pediatrics, Guangdong Medical University, Dongguan 523808, Guangdong Province, China
4. Department of Neonatology, Handan Maternity and Child Health Care Hospital, Handan 056001, Hebei Province, China
5. Department of Neonatology, Chengdu Women and Children′s Central Hospital, Chengdu 610091, China
6. Department of Neonatology, Shaanxi Maternal and Child Health Care Hospital, Xi′an 710003, China
7. Department of Pediatrics, Longgang District Central Hospital of Shenzhen, Shenzhen 518116, Guangdong Province, China
8. Department of Pediatrics, the First Hospital of Jilin University, Changchun 130021, China
9. Department of Neonatology, 302 Military Hospital of China, Beijing 100039, China
10. Department of Pediatrics, Navy General Hospital, Beijing 100048, China
11. Department of Pediatrics, Bethune International Peace Hospital, Shijiazhuang 050082, China
12. Department of Pediatrics, Huangshi Maternal and Child Health Care Hospital, Huangshi 435003, Hubei Province, China
13. Department of Pediatrics, Yantai Yuhuangding Hospital, Yantai 264000, Shandong Province, China
14. Department of Pediatrics, Liaocheng People′s Hospital, Liaocheng 252004, Shandong Province, China
15. Department of Neonatology, Changsha Maternal and Child Health Care Hospital, Changsha 410007, China
16. Department of Neonatology, Peking University Third Hospital, Beijing 100191, China
Publication Type:Journal Article
Keywords: Hypertensive disorders complicating pregnancy; Infants, premature; Complications
From: Chinese Journal of Applied Clinical Pediatrics 2018;33(14):1065-1070
CountryChina
Language:Chinese
Abstract: Objective:To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants.
Methods:The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed.
Results:The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis.
Conclusions:HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.