362 Neonatal growth restriction in pregnancies complicated with preeclampsia

Abstract

Introduction and aims of the study: Hypertensive disorders of pregnancy include pregnancy hypertension (PH), pre-pregnancy hypertension (PPH), and preeclampsia superimposed on either of the two. It complicates 2-4 % of all pregnancies. HDP is associated with several short and long-term perinatal and neonatal complications, like neonatal growth restriction and sometimes also to neonatal death. The aim of this study was to establish association between preeclampsia and growth abnormalities of the neonate, and neonatal death (ND). Methods: The is a single-center retrospective cohort study. A database of 63651 singleton deliveries between 2010 and November 2020 was created using anonymized electronic patient records of Saint Sophia’s Hospital in Warsaw, Poland. Neonatal growth restriction (NGR) was defined as: birth weight less than the < 3rd percentile on population-based or at least 3/5 of: birth weight, length and/or head circumference <10th percentile, prenatal diagnosis of fetal growth restriction, maternal pregnancy information regarding hypertension and/or preeclampsia. This definition was based on the new delphi consensus published in 2018 by Beuned et al. The Intergrowth chart was used to assess birth centiles. Results: They were divided into two study groups Group 1: pregnancy hypertension with superimposed preeclampsia (n = 435), and Group 2: pre-pregnancy hypertension with superimposed preeclampsia (n = 720). Control group consisted of 60540 women without any hypertensive disorder. Both PH with PE and PPH with PE had the remarkable impact on neonatal death OR = 8.08 (95%CI: 2.92–22.3) and OR = 30.12 (95%CI: 7.22–125.7), respectfully. NGR was significantly more often diagnosed in association with pregnancies complicated by PH with PE OR = 24.2 (95%CI: 18.97–30.87) than PPH with PE OR = 20.1 (95%CI: 10.97–36.82). But in both cases the risk was very high. Conclusion: Preeclampsia regardless of PH or PPH had a significant influence on NGR diagnosis and ND.