Growth Abnormalities As a Risk Factor of Adverse Neonatal Outcome in Hypertensive Pregnancies-A Single-Center Retrospective Cohort Study

Overview

Journal Children (Basel)

Specialty Health Services

Date 2021 Jul 2

PMID 34205263

Citations 2

Authors

Anna Kajdy

Stepan Feduniw

Jan Modzelewski

Dorota Sys

Dagmara Filipecka-Tyczka

Katarzyna Muzyka-Placzynska

Pawel Kiczmer

Bartlomiej Grabowski

Michal Rabijewski

Affiliations

Soon will be listed here.

Abstract

(1) Background: Hypertensive disorders of pregnancy (HDP) include gestational hypertension (GH), chronic hypertension (CH), preeclampsia (PE), and preeclampsia superimposed on chronic hypertension (CH with PE). HDP is associated with several short and long-term perinatal and neonatal complications, such as newborn growth restriction and death. This study aimed to establish the association between HDP, newborn growth abnormalities, and neonatal outcome. (2) Methods: This is a single-center retrospective cohort study of 63651 singleton deliveries. (3) Results: Univariate analysis showed a significantly increased risk of intrauterine and neonatal death associated with maternal hypertension and growth disorders. There were differences between growth charts used, with the highest risk of stillbirth for SGA defined by the Intergrowth chart (OR 17.2) and neonatal death for newborn growth restriction (NGR) based on Intergrowth (OR 19.1). Multivariate analysis showed that NGR is a stronger risk factor of neonatal death than SGA only. (4) Conclusions: HDP is significantly associated with growth abnormalities and is an independent risk factor of adverse outcomes. The presence of newborn growth restriction is strongly associated with the risk of neonatal death. The choice of growth chart has a substantial effect on the percentage of diagnosis of SGA and NGR.

Citing Articles

Does Exposure to Ambient Air Pollution Affect Gestational Age and Newborn Weight?-A Systematic Review.

Grabowski B, Feduniw S, Orzel A, Drab M, Modzelewski J, Pruc M Healthcare (Basel). 2024; 12(12).

PMID: 38921290 PMC: 11203000. DOI: 10.3390/healthcare12121176.

Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case-Control Study in Romania.

Bujorescu D, Ratiu A, Citu C, Gorun F, Gorun O, Crisan D J Pers Med. 2023; 13(4).

PMID: 37109031 PMC: 10145500. DOI: 10.3390/jpm13040645.

References

Fenton T, Kim J . A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr. 2013; 13:59. PMC: 3637477. DOI: 10.1186/1471-2431-13-59. View

Chiefari E, Quaresima P, Visconti F, Mirabelli M, Brunetti A . Gestational diabetes and fetal overgrowth: time to rethink screening guidelines. Lancet Diabetes Endocrinol. 2020; 8(7):561-562. DOI: 10.1016/S2213-8587(20)30189-3. View

Barnhart L . HELLP Syndrome and the Effects on the Neonate. Neonatal Netw. 2016; 34(5):269-73. DOI: 10.1891/0730-0832.34.5.269. View

Yu C, Khouri O, Onwudiwe N, Spiliopoulos Y, Nicolaides K . Prediction of pre-eclampsia by uterine artery Doppler imaging: relationship to gestational age at delivery and small-for-gestational age. Ultrasound Obstet Gynecol. 2008; 31(3):310-3. DOI: 10.1002/uog.5252. View

Major C, de Veciana M, Lewis D, Morgan M . Preterm premature rupture of membranes and abruptio placentae: is there an association between these pregnancy complications?. Am J Obstet Gynecol. 1995; 172(2 Pt 1):672-6. DOI: 10.1016/0002-9378(95)90591-x. View

Duffy J, Cairns A, Richards-Doran D, van t Hooft J, Gale C, Brown M . A core outcome set for pre-eclampsia research: an international consensus development study. BJOG. 2020; 127(12):1516-1526. DOI: 10.1111/1471-0528.16319. View

Stoll B, Hansen N, Bell E, Shankaran S, Laptook A, Walsh M . Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics. 2010; 126(3):443-56. PMC: 2982806. DOI: 10.1542/peds.2009-2959. View

Mayrink J, Souza R, Feitosa F, Rocha Filho E, Leite D, Vettorazzi J . Incidence and risk factors for Preeclampsia in a cohort of healthy nulliparous pregnant women: a nested case-control study. Sci Rep. 2019; 9(1):9517. PMC: 6606578. DOI: 10.1038/s41598-019-46011-3. View

Panaitescu A, Baschat A, Akolekar R, Syngelaki A, Nicolaides K . Association of chronic hypertension with birth of small-for-gestational-age neonate. Ultrasound Obstet Gynecol. 2017; 50(3):361-366. DOI: 10.1002/uog.17553. View

10.

Coutinho C, Melchiorre K, Thilaganathan B . Stillbirth at term: Does size really matter?. Int J Gynaecol Obstet. 2020; 150(3):299-305. DOI: 10.1002/ijgo.13229. View

11.

Kajdy A, Modzelewski J, Filipecka-Tyczka D, Pokropek A, Rabijewski M . Development of birth weight for gestational age charts and comparison with currently used charts: defining growth in the Polish population. J Matern Fetal Neonatal Med. 2019; 34(18):2977-2984. DOI: 10.1080/14767058.2019.1676412. View

12.

Umesawa M, Kobashi G . Epidemiology of hypertensive disorders in pregnancy: prevalence, risk factors, predictors and prognosis. Hypertens Res. 2016; 40(3):213-220. DOI: 10.1038/hr.2016.126. View

13.

Raju T, Higgins R, Stark A, Leveno K . Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development. Pediatrics. 2006; 118(3):1207-14. DOI: 10.1542/peds.2006-0018. View

14.

Beune I, Bloomfield F, Ganzevoort W, Embleton N, Rozance P, van Wassenaer-Leemhuis A . Consensus Based Definition of Growth Restriction in the Newborn. J Pediatr. 2018; 196:71-76.e1. DOI: 10.1016/j.jpeds.2017.12.059. View

15.

Bicocca M, Gupta M, Wagner S, Mendez-Figueroa H, Chauhan S . Adverse maternal and neonatal outcomes among low-risk women with obesity at 37-41 weeks gestation. Eur J Obstet Gynecol Reprod Biol. 2020; 254:141-146. DOI: 10.1016/j.ejogrb.2020.08.053. View

16.

Ananth C, Savitz D, Williams M . Placental abruption and its association with hypertension and prolonged rupture of membranes: a methodologic review and meta-analysis. Obstet Gynecol. 1996; 88(2):309-18. DOI: 10.1016/0029-7844(96)00088-9. View

17.

Kawakita T, Parikh L, Ramsey P, Huang C, Zeymo A, Fernandez M . Predictors of adverse neonatal outcomes in intrahepatic cholestasis of pregnancy. Am J Obstet Gynecol. 2015; 213(4):570.e1-8. PMC: 5199141. DOI: 10.1016/j.ajog.2015.06.021. View

18.

. WHO: recommended definitions, terminology and format for statistical tables related to the perinatal period and use of a new certificate for cause of perinatal deaths. Modifications recommended by FIGO as amended October 14, 1976. Acta Obstet Gynecol Scand. 1977; 56(3):247-53. View

19.

Battaglia F, LUBCHENCO L . A practical classification of newborn infants by weight and gestational age. J Pediatr. 1967; 71(2):159-63. DOI: 10.1016/s0022-3476(67)80066-0. View

20.

Desplanches T, Bouit C, Cottenet J, Szczepanski E, Quantin C, Fauque P . Combined effects of increasing maternal age and nulliparity on hypertensive disorders of pregnancy and small for gestational age. Pregnancy Hypertens. 2019; 18:112-116. DOI: 10.1016/j.preghy.2019.09.006. View