Outcomes of singleton small for gestational age preterm infants exposed to maternal hypertension: a retrospective cohort study

ElSayed, Elhaytham; Daspal, Sibasis; Yee, Wendy; Pelausa, Ermelinda; Canning, Rody; Shah, Prakesh S.; Yusuf, Kamran

doi:10.1038/s41390-019-0416-6

Cited by 16 publications

(39 citation statements)

References 39 publications

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“…38 Antenatal corticosteroids have been shown to be used more widely in maternal HTN disorders and are independently associated with reduced neonatal mortality. 15,18,39 In this study, we also found a higher rate of antenatal steroid use in maternal HTN disorders. Interestingly, in regard to the interaction between site of delivery and improved neonatal outcomes, steroid use was found to account for why inborn preterm neonates had less intraventricular hemorrhage than outborn neonates.…”

Section: Discussionsupporting

confidence: 72%

Maternal Hypertension Disorders and Neonatal Acute Kidney Injury: Results from the AWAKEN Study

et al. 2022

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Objective: To examine the association between maternal hypertension (HTN) exposure and neonatal acute kidney injury (AKI). Study Design: Retrospective cohort study of 2162 neonates admitted to 24 NICUs. Neonates were classified into the following exposure groups: any maternal HTN, chronic maternal HTN, preeclampsia/eclampsia, both, or neither. Demographics, clinical characteristics, and AKI status were compared using chi-square and analysis of variance. General estimating logistic regression was used to estimate adjusted odds ratios and included a stratified analysis for site of delivery. Result: Neonates exposed to any maternal HTN disorder had a tendency towards less overall and early AKI. When stratified by inborn versus outborn, exposure to both maternal HTN disorders was associated with a significantly reduced odds of early AKI only in the inborn neonates. Conclusion: Exposure to maternal HTN, especially pre/eclampsia superimposed on chronic HTN, was associated with less likelihood of early AKI in the inborn group.

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Section: Discussionsupporting

confidence: 72%

Maternal Hypertension Disorders and Neonatal Acute Kidney Injury: Results from the AWAKEN Study

et al. 2022

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“…Pregnant women at risk for preterm delivery are often associated with serious complications, for example maternal hypertension, unexplained uterus contraction. The mothers with hypertensive disorders of pregnancy may be monitored more closely and was higher rates of antenatal corticosteroid use [35]. These risk factors cause a higher incidence of asphyxia in preterm infants, leading to a statistical analysis that affected this variable.…”

Section: Discussionmentioning

confidence: 99%

Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study

Wang

Huang

et al. 2020

BMC Pediatr

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Background: The objective of this prospective, multicentre, observational cohort study was to evaluate the association between admission hypothermia and neonatal outcomes in very low-birth weight (VLBW) infants in multiple neonatal intensive care units (NICUs) in China. Methods: Since January 1, 2018, a neonatal homogeneous cooperative research platform-Shandong Neonatal Network (SNN) has been established. The platform collects clinical data in a prospective manner on preterm infants with birth weights (BWs) < 1500 g and gestational ages (GAs) < 34 weeks born in 28 NICUs in Shandong Province. These infants were divided into normothermia, mild or moderate/severe hypothermia groups according to the World Health Organization (WHO) classifications of hypothermia. Associations between outcomes and hypothermia were tested in a bivariate analysis, followed by a logistic regression analysis.

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“…benchmarking of neonatal outcomes, and research on neonatal health [45][46][47][48][49][50][51][52][53][54][55]. These networks have collaborated in NICU studies comparing neonatal outcomes by centre and country, and also studies of prenatal determinants [4][5][6][7][8][9][10][11][12][13]56]. Such studies are particularly vulnerable to bias and can obscure health disparities.…”

Section: Plos Onementioning

confidence: 99%

“…As a consequence, several research initiatives have targeted preterm birth. The Canadian Neonatal Network and other groups have conducted many studies among preterm populations, focusing on prenatal risk factors for perinatal outcomes, or comparing perinatal and neonatal outcomes by health centre and country, in addition to studies of interventions following preterm birth [4][5][6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Bias in comparisons of mortality among very preterm births: A cohort study

et al. 2021

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Background Several studies of prenatal determinants and neonatal morbidity and mortality among very preterm births have resulted in unexpected and paradoxical findings. We aimed to compare perinatal death rates among cohorts of very preterm births (24–31 weeks) with rates among all births in these groups (≥24 weeks), using births-based and fetuses-at-risk formulations. Methods We conducted a cohort study of singleton live births and stillbirths ≥24 weeks’ gestation using population-based data from the United States and Canada (2006–2015). We contrasted rates of perinatal death between women with or without hypertensive disorders, between maternal races, and between births in Canada vs the United States. Results Births-based perinatal death rates at 24–31 weeks were lower among hypertensive than among non-hypertensive women (rate ratio [RR] 0.67, 95% CI 0.65–0.68), among Black mothers compared with White mothers (RR 0.94, 95%CI 0.92–0.95) and among births in the United States compared with Canada (RR 0.74, 95%CI 0.71–0.75). However, overall (≥24 weeks) perinatal death rates were higher among births to hypertensive vs non-hypertensive women (RR 2.14, 95%CI 2.10–2.17), Black vs White mothers (RR 1.86, 95%CI 184–1.88;) and births in the United States vs Canada (RR 1.08, 95%CI 1.05–1.10), as were perinatal death rates based on fetuses-at-risk at 24–31 weeks (RR for hypertensive disorders: 2.58, 95%CI 2.53–2.63; RR for Black vs White ethnicity: 2.29, 95%CI 2.25–2.32; RR for United States vs Canada: 1.27, 95%CI 1.22–1.30). Conclusion Studies of prenatal risk factors and between-centre or between-country comparisons of perinatal mortality bias causal inferences when restricted to truncated cohorts of very preterm births.

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Outcomes of singleton small for gestational age preterm infants exposed to maternal hypertension: a retrospective cohort study

Cited by 16 publications

References 39 publications

Maternal Hypertension Disorders and Neonatal Acute Kidney Injury: Results from the AWAKEN Study

Maternal Hypertension Disorders and Neonatal Acute Kidney Injury: Results from the AWAKEN Study

Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study

Bias in comparisons of mortality among very preterm births: A cohort study

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