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The relation between pre-eclampsia at term and neonatal encephalopathy.

L Impey1, C Greenwood, O Sheil

  • 1Department of Obstetrics and Gynaecology, The Women's Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK. Lawrence.Impey@orh.nhs.uk

Archives of Disease in Childhood. Fetal and Neonatal Edition
|October 23, 2001
PubMed
Summary

Pre-eclampsia is linked to maternal fever during labor, supporting its inflammatory nature. This condition also strongly correlates with neonatal encephalopathy, independent of labor interventions.

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Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Perinatal Research

Background:

  • Pre-eclampsia is a pregnancy complication characterized by high blood pressure and potential organ damage.
  • The inflammatory nature of pre-eclampsia is hypothesized but not fully understood.
  • Previous studies suggest a link between pre-eclampsia and adverse neonatal outcomes.

Purpose of the Study:

  • To investigate the association between pre-eclampsia and maternal fever during term labor.
  • To confirm and examine the relationship between term pre-eclampsia and neonatal encephalopathy.
  • To explore potential underlying mechanisms for these associations.

Main Methods:

  • Prospective cohort study involving 6163 women in labor at term.
  • Data collected from a Dublin teaching hospital as part of a randomized trial.

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  • Analysis included odds ratios and adjusted odds ratios to assess associations and control for confounding factors.

    • Main Results:

    • Pre-eclampsia was significantly associated with maternal fever (>37.5°C) in labor (adjusted OR 2.07).
    • A strong association was found between pre-eclampsia and neonatal encephalopathy (adjusted OR 18.5), independent of obstetric interventions.
    • The link between pre-eclampsia and encephalopathy persisted even after accounting for maternal fever and cord acidemia.

    Conclusions:

    • Findings support the hypothesis that pre-eclampsia is an inflammatory condition.
    • The association between pre-eclampsia and neonatal encephalopathy is robust and not explained by labor interventions, fever, or acidemia.
    • A fetal inflammatory response, possibly due to oxidative stress leading to cerebral vasoconstriction, may explain the link to neonatal encephalopathy.