Study of Risk Factors Contributing to Adverse Neonatal Outcome in Hypertensive Mothers Compared to Non Hypertensive Mothers

Abstract

AIM:To study the various risk factors in hypertensive mothers that contribute to adverse neonatal outcome in the form of low birth weight when compared to non-hypertensive mothers. SETTING: The study was conducted in the Inborn NICU and New born Follow up clinic of Department of Paediatrics in a rural Government medical college Hospital. STUDY DESIGN: Prospective cohort study. MATERIALS AND METHODS: INCLUSION CRITERIA: CASES: Consecutive sample of mothers with pregnancy induced hypertension during the study period who have given consent for the study were interviewed and their live born babies were included as cases. CONTROLS: Consecutive sample of live born babies born to non-hypertensive mothers in the same study period were included as controls. Exclusion Criteria: Babies with major congenital anomalies chromosomal anomalies, intrauterine death were excluded. METHODOLOGY: Details of maternal risk factors were collected. Anthropometric parameters, systemic examination, development and maturity of the babies were assessed. STATISTICAL TESTING: Significance testing was done using chi square test, odds ratio, analysis of risk ratios and correlation testing. P values greater than .05 were considered non-significant. Spss 16 Software package was used for statistical analysis. RESULTS: The incidence of low birth weight in this study was 45.6% which is considerably higher than in controls (16.6%) and in the general population (19.1%). 33.8% of babies were preterm among the cases compared to 6.1% among controls.Among mothers with hypertension detected before 30 weeks, 90.3% had low birth weight babies. Among mothers with severe hypertension, 86.4% had low birth weight babies compared to 29.8% among those with mild hypertension.92.3% pregnancies with Doppler abnormalities had LBW. 70.8% of LBW babies had antenatal intra uterine growth restriction.90.1% of hypertensive mothers with albuminuria had associated LBW. 100% babies had low birth weight when mother had eclampsia and renal function abnormality. CONCLUSION: Risk factors associated with hypertension have a link with low birth weight and adverse outcome in babies.