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Maternal preeclampsia and respiratory outcomes in extremely premature infants

Thea Tagliaferro1, Deepak Jain1, Silvia Vanbuskirk1

  • 1Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.

Pediatric Research
|February 17, 2019
PubMed

Insights

Preeclampsia exposure increases the risk of severe respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) in extremely premature infants. Further research is needed to understand the underlying mechanisms of this association.

Area of Science:

  • Neonatal Medicine
  • Perinatal Research
  • Respiratory Physiology

Background:

  • Preeclampsia (PE) creates an anti-angiogenic environment, potentially impacting fetal lung development.
  • Existing data on PE's effect on respiratory outcomes in extremely premature infants is inconclusive.
  • This study investigates the association between PE and severe respiratory complications in this vulnerable population.

Purpose of the Study:

  • To determine if preeclampsia is associated with an increased risk of severe respiratory distress syndrome (RDS).
  • To assess the association between preeclampsia and bronchopulmonary dysplasia (BPD) in extremely premature infants.
  • To analyze respiratory outcomes in infants born between 23-28 weeks gestational age exposed to PE.

Main Methods:

  • Analysis of prospectively collected single-center data from 1218 infants (23-28 weeks gestational age, 2005-2015).
  • Logistic regression and generalized estimating equations were used to model the association between PE and respiratory outcomes.
  • Severe RDS defined as ≥30% supplemental oxygen on day 1; BPD and severe BPD defined by oxygen requirements at 36 weeks postmenstrual age.

Main Results:

  • 23% of the cohort (1218 infants) were exposed to preeclampsia.
  • Preeclampsia exposure was significantly associated with an increased risk of severe RDS.
  • Preeclampsia was also linked to a higher risk of severe bronchopulmonary dysplasia in infants alive at 36 weeks postmenstrual age.

Conclusions:

  • Exposure to preeclampsia is an independent risk factor for severe RDS in extremely premature infants.
  • Preeclampsia is associated with adverse respiratory outcomes, including severe BPD, in this population.
  • Further investigation into the mechanisms linking preeclampsia to infant respiratory issues is warranted.
Abstract

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