Increased rate of small-for-gestational-age neonates in pre-eclamptic women with preterm deliveries

We sought to determine whether hypertensive pregnancies can be considered a distinct subgroup of premature births. All women in our centre who had had singleton preterm spontaneous deliveries over an 8-year period were divided into hypertensive and normotensive groups and compared for maternal characteristics and neonatal outcome. Of the 4175 eligible women, 9.8% (n = 410) had pre-eclampsia. These patients had higher rates of small-for-gestational-age neonates (19%, 78/410), abruptio placenta (7.8%, 32/410) and caesarean section rate (52.7%, 216/410) than the normotensive women (4.3%, 158/3765; 4.6%, 172/3765; and 19.6%, 739/3765, P < 0.001, respectively. The rate of preterm premature rupture of membranes was significantly lower in the hypertensive than in the normotensive group (5.9% vs. 17%, respectively; P < 0.001). We concluded that hypertensive women who deliver prematurely belong to a subgroup with particular characteristics. The increased rate of small-for-gestational-age neonates in pre-eclamptic women suggests that reduced uteroplacental perfusion may cause fetal growth impairment before the onset of the hypertensive disorder.