Extragenital diseases in patients with preterm delivery caused by preeclampsia and/or fetal growth restriction

Abstract

Aim. To determine the influence of extragenital diseases and their combinations on the development of placental insufficiency manifesting as heavy preeclampsia and/or antenatal distress of fetus as indications for preterm delivery. Methods. The retrospective study based on medical charts of patients with delivery term of 28 to 36 weeks of gestation caused by heavy preeclampsia and/or antenatal distress of fetus was performed. Results. In case of the deliveries at 28-33 weeks of gestation caused by preeclampsia and fetal growth restriction, arterial hypertension was present in 42.8% of cases, combination of arterial hypertension and obesity - in 33.3%; at 34-36 weeks of gestation hypertension was revealed in 40%, obesity - in 22.5% of cases. In case of the deliveries at 28-33 weeks of gestation caused by preeclampsia, diabetes was present in 42.6% of cases, the combination of arterial hypertension and obesity - in 17.6%; at 34-36 weeks of gestation obesity was registered in 34.1% of cases. In patients with fetal growth restriction who delivered off at 28-33 weeks of gestation, arterial hypertension was diagnosed in 20.2% of cases; in patients who delivered off at 34-36 weeks of gestation, chronic diseases of upper respiratory tract were revealed in 21.4% of cases. Conclusion. The risk factors of pregnancy complicated by heavy preeclampsia and fetal growth restriction are arterial hypertension and obesity, whereas the combination of these factors increases the risk for pre-term delivery before 33 weeks of gestation eight-fold. The risk factors of pregnancy complicated by heavy preeclampsia without fetal growth restriction are diabetes mellitus type I and obesity (it increases the risk for pre-term delivery before 33 weeks of gestation four-fold if associated with arterial hypertension). The risk factors of pregnancy complicated by fetal growth restriction and antenatal distress of fetus are chronic diseases of upper respiratory tract, whereas arterial hypertension increases the risk of pre-term delivery before 33 weeks of gestation three-fold.