77 High blood pressure during pregnancy is not a protective factor for preterm infants with very low weight. A case-control study: Gestational hypertension

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• 作者：Annibal Tagliaferri Sabino ; Eduardo de Souza ; Ana Lucia Goulart ; Adriana Martins de Lima ; Nelson Sass
• 关键词：Keywords ; Prematurity ; Prognosis ; Preeclampsia ; Mortality
• 刊名：Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：6
• 期：3
• 页码：215
• 全文大小：175 K

文摘

To evaluate morbidity and mortality, during the first 24 months of postconceptual age, of children with very low birth weight, whose mothers were diagnosed with gestational hypertensive disorders and compare them with very low birth weight children from otherwise etiologies.

Methods

Retrospective cohort study, which included preterm children, with birth weight lower than 1.500 g, born at the Hospital São Paulo of the Federal University of São Paulo, between 2.004 and 2.007, whose mothers received prenatal care and obstetrical assistance during hospital stay, and were followed up until 24 months of corrected age.

Resulsts

93 Patients were selected, including 49 children whose mothers were diagnosed with hypertension and 44 without such disease. Seven (14.3%) children from the group of hypertensive mothers died before hospital discharge. Among the 42 survivors, 14 (33.3%) were not followed up (no follow-up group) and 28 (66.7%) were eligible for analysis. Among the 44 children without the hypertensive history, 12 (27.2%) died before discharge. Among the 32 remaining, 11 (34.4%) were not followed up (no follow-up group) and 21 (65.6%) were assessed. There was no significant statistical difference in the hospital mortality rates of both groups and the overall mortality was 20.4%. The number of deaths was higher among children with birth weight lower than 1000 g (p < 0,001). Our results, regarding maternal and antenatal features, were as follows: hypertensive mothers received corticosteroids (p = 0,015) and magnesium sulfate (p < 0.001) more frequently; had a higher cesarean section delivery rate (p < 0.001) and presented a higher incidence of fetal blood flow redistribution (p < 0.001). The comparison between the two groups of children, during hospital stay, showed that lower Apgar scores (p = 0.011), lower gestational age at birth (p = 0.044) and bronchopulmonary dysplasia (p = 0.007) were all more prevalent in the no maternal hypertension group. The remaining variables showed no statistically significant differences between the two groups. At 24 months of corrected age, there were no statistically significant differences for all variables.

Conclusion

We have identified a high prevalence of perinatal complications in our whole sample. Preterm delivery remains a major and complex health problem, accounting for most of neonatal morbidity and mortality, not to mention the high prevalence of sequels among survivors, no matter its cause. The authors thank FAPESP (Process 2014/00213-7) for its support in the execution of this work.