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Growth Abnormalities as a Risk Factor of Adverse Neonatal Outcome in Hypertensive Pregnancies-A Single-Center

Anna Kajdy1, Stepan Feduniw1, Jan Modzelewski1

  • 1Department of Reproductive Health, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland.

Children (Basel, Switzerland)
|July 2, 2021
PubMed

Insights

Hypertensive disorders of pregnancy (HDP) increase risks for newborns, including growth restriction and death. Newborn growth restriction is a significant predictor of neonatal mortality, underscoring the impact of maternal hypertension on infant outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Perinatal Medicine
  • Maternal-Fetal Medicine

Background:

  • Hypertensive disorders of pregnancy (HDP) encompass gestational hypertension, chronic hypertension, preeclampsia, and superimposed preeclampsia.
  • HDP is linked to adverse perinatal and neonatal outcomes, including intrauterine growth restriction and mortality.
  • Understanding the specific associations between HDP, newborn growth abnormalities, and neonatal outcomes is crucial for clinical management.

Purpose of the Study:

  • To investigate the association between hypertensive disorders of pregnancy (HDP) and newborn growth abnormalities.
  • To determine the impact of HDP and growth disorders on neonatal outcomes, specifically neonatal death.
  • To compare the influence of different growth charts on the diagnosis of small for gestational age (SGA) and newborn growth restriction (NGR).

Main Methods:

  • A single-center retrospective cohort study.
  • Inclusion of 63,651 singleton deliveries.
  • Analysis of associations between maternal hypertension, newborn growth parameters, and neonatal outcomes.

Main Results:

  • Univariate analysis revealed increased risks of intrauterine and neonatal death associated with maternal hypertension and growth disorders.
  • Newborn growth restriction (NGR) was identified as a stronger independent risk factor for neonatal death compared to small for gestational age (SGA) alone.
  • The choice of growth chart significantly affected the diagnostic rates of SGA and NGR, with the Intergrowth chart showing the highest risk for stillbirth and neonatal death.

Conclusions:

  • Hypertensive disorders of pregnancy are significantly associated with fetal growth abnormalities and are independent risk factors for adverse neonatal outcomes.
  • Newborn growth restriction demonstrates a strong association with an increased risk of neonatal death.
  • The selection of appropriate growth charts is critical, as it substantially impacts the diagnosis of SGA and NGR and subsequent risk assessment.

Keywords:
composite neonatal outcomegrowth chartintrauterine deathlarge for gestational ageneonatal deathneonatal growth restrictionpreeclampsiapregnancy hypertensionprepregnancy hypertensionsmall for gestational age

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