Preterm Preeclampsia with Severe Features: Composite Maternal and Neonatal Morbidities Associated with Fetal Growth Restriction

Balogun, Olaide A. Ashimi; Khanagura, Raminder K.; Kregel, Heather R.; Amro, Farah H.; Sibai, Bahaeddine M; Chauhan, Suneet P.

doi:10.1055/s-0037-1617456

Cited by 13 publications

(5 citation statements)

References 10 publications

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“…It is associated with the development of hypertension and proteinuria after 20 weeks of pregnancy in previously normotensive and non-proteinuric women [ 4 , 5 ]. It complicates between 3% and 5% of pregnancies [ 1 , 6 , 7 , 8 ]. It is one of the leading causes of maternal and perinatal morbidities and mortalities around the world [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…It is one of the leading causes of maternal and perinatal morbidities and mortalities around the world [ 1 , 2 ]. It is responsible for 76,000 maternal and 500,000 perinatal deaths annually [ 1 , 6 , 7 , 8 ] and 192 maternal deaths daily [ 7 ]. These figures demonstrate the enormity of the ills of pre-eclampsia and the need to find ways of preventing the complications associated with it.…”

Section: Introductionmentioning

confidence: 99%

“…Others include: primipaternity, primigravidity, teenage pregnancy, and age above 35 years [ 5 , 9 ]. It is regarded as a disease of theories, and finding definitive pathophysiology remains elusive [ 1 , 4 , 5 , 7 , 8 , 9 , 10 , 11 ]. Inefficient remodeling of the smooth muscles of the spiral arterioles of the uterine endometrium due to failure of the second wave of trophoblastic invasion has been implicated [ 4 , 6 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Correlation of platelet parameters with adverse maternal and neonatal outcomes in severe preeclampsia: A case-control study

Umezuluike

Nnachi

Iwe

et al. 2021

Heliyon

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Background: Pre-eclampsia (PET) is a potentially devastating multi-systemic disorder resulting in the generation of oxidative stress. Platelet activation causes vasoconstriction and release of inflammatory cytokines, resulting in an intensified inflammatory response, endothelial damage, and coagulopathy which culminate in adverse pregnancy outcomes. Aim: To compare the platelet parameters between preeclamptic and normotensive pregnant women and their relationship to adverse outcomes in women with pre-eclampsia. Materials and methods: This was a case-control study of platelet indices of 60 pre-eclamptic and 60 normotensive pregnant women recruited at 28 weeks and followed till delivery. A blood sample was collected at entry into the study and just before delivery. The sample was analyzed within 1 h of collection using the Mythic 18 hematological auto-analyzer. Data were analyzed using IBM-SPSS version 22. A P-value of <0.05 was considered statistically significant. Results: The mean platelet count, Platelet distribution width (PDW), plateletcrit were statistically significantly different between normotensive and severe preeclamptic participants (p¼ <0.001). Statistically significant differences were not present in any of the platelet parameters between mild and severe PET. The odds of developing eclampsia was low at higher mean platelet count and plateletcrit levels above 161.36 AE 73.74 Â 10 9 /L [p ¼ 0.02, AOR ¼ 0.27, 95% CI (0.08-0.88)] and 0.13 AE 0.05% [p ¼ 0.001, AOR ¼ 0.22, 95% CI (0.08-0.58)] respectively. Eclampsia was strongly associated with P-LCR (platelet-large cell ratio) above 23.15 AE 4.92% [p ¼ 0.004, AOR ¼ 11.00, ]. Abruptio placentae had low odds at lower levels of mean plateletcrit. Pre-term birth was significantly lower at mean plateletcrit levels above 0.14 AE 0.05%; admission into neonatal intensive care unit was strongly associated with a mean PLC ratio above 22.73 AE 5.91%. Conclusion: This study demonstrated significant differences in platelet count, plateletcrit, platelet distribution width, and P-LCR between pre-eclamptic and normotensive women. Increase in P-LCR is a risk factor for eclampsia although the effect size is low.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Correlation of platelet parameters with adverse maternal and neonatal outcomes in severe preeclampsia: A case-control study

Umezuluike

Nnachi

Iwe

et al. 2021

Heliyon

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“…Preeclampsia is a pregnancy-specific disorder resulting in hypertension and multiorgan dysfunction, 1 and is a leading cause of maternal and neonatal morbidity and mortality, affecting patients’ long-term quality of life. 2 Low-dose administration of aspirin before 16 weeks of gestation has been reported to effectively reduce preterm preeclampsia. 3 Therefore, novel biomarkers with high sensitivity and specificity are needed to contribute to early screening of high-risk patients, in order to effectively prevent or delay the occurrence and development of preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

Abnormal expression and clinical significance of 25-hydroxyvitamin D and sFlt-1 in patients with preeclampsia

Chen

Cui

et al. 2019

J Int Med Res

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Objective To determine the association between levels of serum 25-hydroxyvitamin D (25[OH]D) and soluble fms-like tyrosine kinase 1 (sFlt-1) in patients with preeclampsia. Methods Clinical and demographic data were collected from patients with preeclampsia and healthy pregnant controls. Serum 25(OH)D and sFlt-1 levels were evaluated by enzyme-linked immunosorbent assay and their correlations were determined using Spearman’s rank correlation coefficient. Associations between serum 25(OH)D and sFlt-1 levels and disease severity and clinical parameters were evaluated. Results Significantly lower serum 25(OH)D and higher sFlt-1 levels were observed in patients with preeclampsia ( n = 100) versus controls ( n = 100), and 25(OH)D was inversely correlated with sFlt-1 in patients with preeclampsia. Serum 25(OH)D levels were reduced, while sFlt-1 concentration was increased in patients with severe versus mild preeclampsia. Serum 25(OH)D levels were reduced in late-onset versus early-onset severe preeclampsia. Patients with preeclampsia who had lower serum 25(OH)D or elevated sFlt-1 levels showed significantly higher blood pressure indexes versus those with higher 25(OH)D or lower sFlt-1. Conclusions Low serum 25(OH)D and high sFlt-1 may be candidate biomarkers for preeclampsia diagnosis and prognosis.

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“…Balogun et al [24] claimed that preterm preeclamptic parturients with fetal growth restriction have higher composite maternal and neonatal morbidity risk than appropriate for gestational age cases. Similarly, Haddad et al [25] showed that severe fetal growth restriction is associated with increased fetal death risk while maternal complications were not different in preterm severe preeclampsia cases.…”

Section: Discussionmentioning

confidence: 99%

The role of oligohydramnios and fetal growth restriction in adverse pregnancy outcomes in preeclamptic patients

et al. 2022

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Preterm Preeclampsia with Severe Features: Composite Maternal and Neonatal Morbidities Associated with Fetal Growth Restriction

Abstract: Women with preterm PE with severe features and FGR, when compared with those with AGA, have significantly higher risk of CMM and CNM.

Cited by 13 publications

References 10 publications

Correlation of platelet parameters with adverse maternal and neonatal outcomes in severe preeclampsia: A case-control study

Correlation of platelet parameters with adverse maternal and neonatal outcomes in severe preeclampsia: A case-control study

Abnormal expression and clinical significance of 25-hydroxyvitamin D and sFlt-1 in patients with preeclampsia

The role of oligohydramnios and fetal growth restriction in adverse pregnancy outcomes in preeclamptic patients

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