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Impact of pre‐eclampsia in extremely premature infants: Population‐based study
Author(s) -
Tokumasu Hironobu,
Tokumasu Satoko,
Kawakami Koji
Publication year - 2016
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12905
Subject(s) - medicine , eclampsia , gestational age , obstetrics , chorioamnionitis , population , cohort , cohort study , pediatrics , pregnancy , genetics , environmental health , biology
Background The relationship between chorioamnionitis (CAM) and neonatal mortality has been extensively investigated, but that of maternal pre‐eclampsia and neonatal mortality is unclear. We investigated neonatal mortality and morbidity of maternal pre‐eclampsia and clinical CAM in extremely premature infants using data from a population‐based cohort study. Methods We retrospectively analyzed data obtained from the Neonatal Research Network in Japan , a population‐based cohort study ( n = 18 900) conducted to clarify the clinical characteristics and morbidity of very low‐birthweight infants. Patients were divided into four diagnosis‐based groups for comparative analysis: sole pre‐eclampsia; sole clinical CAM; concurrent pre‐eclampsia and clinical CAM; and non‐diagnosis (of pre‐eclampsia and clinical CAM). Results Mortality was higher in the pre‐eclampsia groups compared with the groups without (18.3%, 84/459 vs 14.0%, 567/4059; OR, 1.38; 95%CI: 1.07–1.78). In contrast, mortality was not affected by presence of clinical CAM (with, 13.7% 182/1328 vs without, 15.0% 469/3190; OR, 0.92; 95%CI: 0.77–1.11). With regard to small for gestational age, the mortality rate increased by two–three‐fold as gestational week decreased. The complication survival rate in the whole group was 35% (1135/3218). Conclusions Maternal pre‐eclampsia is associated with poor prognosis in extremely premature infants. We also need to deliberate on the trade‐off between the advantages of early rescue from pre‐eclampsia and risk of prematurity.