Pre-eclampsia leads to adverse respiratory outcomes in extremely premature neonates
Extremely premature neonates who have been exposed to pre-eclampsia in utero are at high risk of developing severe respiratory distress syndrome (RDS) and severe bronchopulmonary dysplasia (BPD), according to a study.
Researchers examined a cohort of 1,218 infants born at 23–28 weeks of gestational age, among whom 23 percent were exposed to pre-eclampsia. Exposed infants, when compared with those who were not, were of a higher gestational age (26.2 vs 25.5 weeks; p<0.001) but weighed less (739 vs 830 g; p<0.001) at birth.
In the group of infants who were alive at the end of day 1 (n=1,190), severe RDS occurred with greater frequency in the pre-eclampsia group than in the nonexposed group. Logistic regression models showed that pre-eclampsia was associated with an elevated risk of incident severe RDS (odds ratio [OR], 2.4; 95 percent CI, 1.8–3.3). Analysis by generalized estimating equations (GEE), which controlled for correlation between siblings, confirmed the association (OR, 2.31; 1.59–3.34).
Among infants who were alive at 36 weeks postmenstrual age (n=1,033), significantly more infants in the pre-eclampsia group developed BPD and severe BPD than in the nonexposed group. Logistic regression revealed a relationship between the pregnancy disorder and increased risks of BPD (OR, 1.64; 1.12–2.40) and severe BPD (OR, 2.18; 1.45–3.28).
On GEE analysis, however, the association remained significant for severe BPD (OR, 2.17; 1.41–3.33) only.
The findings highlight the need to further explore the processes triggered by pre-eclampsia, as well as to develop strategies for early detection and treatment that could avert some of the harmful effects on foetal development and neonatal respiratory outcomes, according to researchers.