Effects of Pregnancy-induced Hypertension on Early-onset Neonatal Thrombocytopenia

Overview

Journal BMC Pregnancy Childbirth

Publisher Biomed Central

Date 2025 Jan 25

PMID 39856602

Authors

Meiling Ye

Cailing Zhou

Lu Li

Lizhen Wang

Meixian Zhang

Affiliations

Soon will be listed here.

Abstract

Background: Gestational hypertension and preeclampsia are potentially linked to similar pathophysiological processes. Maternal preeclampsia increases the occurrence of early-onset neonatal thrombocytopenia. We hypothesized that maternal gestational hypertension may impact the incident early-onset neonatal thrombocytopenia.

Methods: We included 538 neonates, comprising 318 and 220 neonates born to healthy mothers and those with pregnancy-induced hypertension. The minimum platelet count within 72 h of birth was recorded for these neonates. The incidence of early-onset thrombocytopenia in neonates in relation to maternal gestational hypertension, preeclampsia, and health status was evaluated. Logistic regression analysis was conducted to assess the relationship between maternal gestational hypertension and the risk of early-onset neonatal thrombocytopenia.

Results: The incidence of early-onset thrombocytopenia was significantly higher in neonates born to mothers with preeclampsia than in those born to mothers with gestational hypertension or healthy mothers. Significant differences were observed among the three groups (30.0% vs. 13.3% vs. 7.9%, p < 0.001). Maternal gestational hypertension (OR = 2.79, 95%CI 1.19-6.54) increased the risk of early-onset neonatal thrombocytopenia when compared to healthy mothers.

Conclusions: Maternal gestational hypertension increases the occurrence of early-onset neonatal thrombocytopenia. Therefore, we recommend conducting platelet count screening at the early stages of neonates of mothers with gestational hypertension.

References

Ramesh Bhat Y, Cherian C . Neonatal thrombocytopenia associated with maternal pregnancy induced hypertension. Indian J Pediatr. 2008; 75(6):571-3. DOI: 10.1007/s12098-008-0110-x. View

Roberts I, MURRAY N . Neonatal thrombocytopenia: causes and management. Arch Dis Child Fetal Neonatal Ed. 2003; 88(5):F359-64. PMC: 1721612. DOI: 10.1136/fn.88.5.f359. View

Erez O, Romero R, Jung E, Chaemsaithong P, Bosco M, Suksai M . Preeclampsia and eclampsia: the conceptual evolution of a syndrome. Am J Obstet Gynecol. 2022; 226(2S):S786-S803. PMC: 8941666. DOI: 10.1016/j.ajog.2021.12.001. View

Hnat M, Sibai B, Caritis S, Hauth J, Lindheimer M, MacPherson C . Perinatal outcome in women with recurrent preeclampsia compared with women who develop preeclampsia as nulliparas. Am J Obstet Gynecol. 2002; 186(3):422-6. DOI: 10.1067/mob.2002.120280. View

Bolat A, Gursel O, Kurekci E, Atay A, Ozcan O . Blood parameters changes in cord blood of newborns of hypertensive mothers. Eur J Pediatr. 2013; 172(11):1501-9. PMC: 3825049. DOI: 10.1007/s00431-013-2072-x. View

Minhas A, Ogunwole S, Vaught A, Wu P, Mamas M, Gulati M . Racial Disparities in Cardiovascular Complications With Pregnancy-Induced Hypertension in the United States. Hypertension. 2021; 78(2):480-488. PMC: 8266726. DOI: 10.1161/HYPERTENSIONAHA.121.17104. View

Binder J, Palmrich P, Pateisky P, Kalafat E, Kuessel L, Zeisler H . The Prognostic Value of Angiogenic Markers in Twin Pregnancies to Predict Delivery Due to Maternal Complications of Preeclampsia. Hypertension. 2020; 76(1):176-183. DOI: 10.1161/HYPERTENSIONAHA.120.14957. View

Stanworth S, Mumford A . How I diagnose and treat neonatal thrombocytopenia. Blood. 2023; 141(22):2685-2697. DOI: 10.1182/blood.2022018017. View

Brady M . Health care-associated infections in the neonatal intensive care unit. Am J Infect Control. 2005; 33(5):268-75. PMC: 7119124. DOI: 10.1016/j.ajic.2004.11.006. View

10.

Leanos-Miranda A, Mendez-Aguilar F, Ramirez-Valenzuela K, Serrano-Rodriguez M, Berumen-Lechuga G, Molina-Perez C . Circulating angiogenic factors are related to the severity of gestational hypertension and preeclampsia, and their adverse outcomes. Medicine (Baltimore). 2017; 96(4):e6005. PMC: 5287982. DOI: 10.1097/MD.0000000000006005. View

11.

. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020; 135(6):e237-e260. DOI: 10.1097/AOG.0000000000003891. View

12.

Arce-Lopez K, Iglesias-Leboreiro J, Bernardez-Zapata I, Rendon-Macias M, Miranda Madrazo M . Hematological disorders in preterm newborns born to mothers with pregnancy-induced hypertension. Bol Med Hosp Infant Mex. 2022; 79(6):363-368. DOI: 10.24875/BMHIM.22000069. View

13.

Nolasco-Leanos A, Ramirez-Valenzuela K, Carrillo-Juarez R, Molina-Perez C, Isordia-Salas I, Leanos-Miranda A . Circulating angiogenic factors are associated with progression to preeclampsia and the occurrence of adverse outcomes in women with gestational hypertension. J Hypertens. 2020; 39(3):573-580. DOI: 10.1097/HJH.0000000000002669. View

14.

Tsao P, Wei S, Su Y, Chou H, Chen C, Hsieh W . Excess soluble fms-like tyrosine kinase 1 and low platelet counts in premature neonates of preeclamptic mothers. Pediatrics. 2005; 116(2):468-72. DOI: 10.1542/peds.2004-2240. View

15.

Mezgebu T, Ossabo G, Zekiwos A, Mohammed H, Demisse Z . Neonatal sepsis and its associated factors among neonates admitted to the neonatal intensive care unit in Wachemo University Comprehensive Specialized Hospital, Southern Ethiopia, 2022. Front Pediatr. 2023; 11:1184205. PMC: 10350534. DOI: 10.3389/fped.2023.1184205. View

16.

Aye I, Aiken C, Charnock-Jones D, Smith G . Placental energy metabolism in health and disease-significance of development and implications for preeclampsia. Am J Obstet Gynecol. 2020; 226(2S):S928-S944. DOI: 10.1016/j.ajog.2020.11.005. View

17.

Villar J, Carroli G, Wojdyla D, Abalos E, Giordano D, Baaqeel H . Preeclampsia, gestational hypertension and intrauterine growth restriction, related or independent conditions?. Am J Obstet Gynecol. 2006; 194(4):921-31. DOI: 10.1016/j.ajog.2005.10.813. View

18.

Bayoumi M, Ali A, Hamad S, Ali A, Elmalik E, Elkalaf M . Effect of Maternal Preeclampsia on Hematological Profile of Newborns in Qatar. Biomed Res Int. 2020; 2020:7953289. PMC: 7097766. DOI: 10.1155/2020/7953289. View

19.

Wight N . ABM Clinical Protocol #1: Guidelines for Glucose Monitoring and Treatment of Hypoglycemia in Term and Late Preterm Neonates, Revised 2021. Breastfeed Med. 2021; 16(5):353-365. DOI: 10.1089/bfm.2021.29178.new. View

20.

Litt J, Hecht J . Placental pathology and neonatal thrombocytopenia: lesion type is associated with increased risk. J Perinatol. 2014; 34(12):914-6. DOI: 10.1038/jp.2014.117. View