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Published on: November 20, 2015
Isolated oligohydramnios and long-term neurological morbidity of the offspring
Avital Dorot1, Tamar Wainstock2, Eyal Sheiner3
1Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Insights
Maternal isolated oligohydramnios (IO) is linked to increased long-term neurological complications in offspring. This study found higher rates of developmental and neurological disorders in children exposed to IO during pregnancy.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Epidemiology
Background:
- Isolated oligohydramnios (IO) is a pregnancy complication with potential long-term effects on offspring development.
- Understanding the association between IO and neurological outcomes is crucial for clinical management and parental counseling.
Purpose of the Study:
- To investigate the association between maternal isolated oligohydramnios (IO) and the risk of long-term neurological complications in offspring.
- To quantify the risk of specific neurological disorders in children born after pregnancies complicated by IO.
Main Methods:
- A population-based retrospective cohort study including over 190,000 births between 1991 and 2014.
- Exclusion of multiple pregnancies and other pregnancy complications to focus on isolated IO.
- Utilized linked obstetrical and pediatric hospitalization databases, employing Kaplan-Meier survival curves and Weibull regression models to analyze neurological hospitalization rates and risks, adjusting for confounders.
Main Results:
- Isolated oligohydramnios (IO) occurred in 2.13% of pregnancies (4063 cases).
- Neurological-related hospitalizations were significantly more common in the IO group (3.7% vs. 3.0%, p=0.005).
- Specific diagnoses including pervasive developmental disorder, movement disorders, and degenerative disorders were significantly higher in the IO-exposed group, with an adjusted hazard ratio of 1.203 (95% CI 1.02-1.42) for long-term neurological morbidity.
Conclusions:
- Pregnancies complicated by isolated oligohydramnios (IO) are significantly associated with an increased risk of long-term neurological morbidity in offspring.
- The findings highlight the importance of monitoring and potential interventions for pregnancies with IO to mitigate adverse neurological outcomes.
Abstract:
This study aimed to assess the association between maternal-isolated oligohydramnios (IO) and offspring long-term neurological complications. A population-based retrospective cohort study was conducted, including all births at a single tertiary medical center in Israel between the years 1991 and 2014. Multiple pregnancies and potential pregnancy complications associated with oligohydramnios were excluded. The computerized obstetrical database was linked with the computerized dataset of all pediatric hospitalizations of the same medical center. Evaluation of cumulative neurological-associated hospitalizations rate over time was compared using a Kaplan-Meier survival curve. The Weibull survival parametric model was conducted to assess the neurological-associated hospitalization risk in the presence of IO, while accounting for potential confounders. A total of 190,259 pregnancies were included in the study, of which 4063 (2.13%) pregnancies were complicated with IO. Total neurological-related hospitalizations were significantly more common in the IO group (3.7% in the IO group and 3.0% in the comparison group, p = 0.005). Pervasive developmental disorder, movement disorders, developmental disorders, and degenerative and demyelization disorders were all specific neurological diagnoses significantly more common in the exposed group. The survival curve demonstrated a significantly higher cumulative hospitalization rate in the exposed group (log-rank p = 0.001). Using a multivariate model adjusting for gestational age, maternal age, and labor induction, an independent association between IO and long-term neurological morbidity of the offspring was observed (adjusted hazard ratio 1.203; 95% CI 1.02-1.42). In summary, a significant association was found between pregnancies complicated by IO and long-term neurological morbidity of the offspring.
