Clinical features of very preterm small-for-gestational-age infants born due to severe preeclampsia

LI Ting, ZHU Li-Min, ZHANG Yan-Ping, KONG Xiang-Yong, XU Hai-Bin

Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (3) : 254-258.

PDF(1377 KB)
PDF(1377 KB)
Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (3) : 254-258. DOI: 10.7499/j.issn.1008-8830.2011006
CLINICAL RESEARCH

Clinical features of very preterm small-for-gestational-age infants born due to severe preeclampsia

  • LI Ting, ZHU Li-Min, ZHANG Yan-Ping, KONG Xiang-Yong, XU Hai-Bin
Author information +
History +

Abstract

Objective To study the clinical features of very preterm small-for-gestational-age infants born by cesarean section due to severe preeclampsia. Methods Forty-two small-for-gestational-age infants who were admitted from August 2017 to July 2018 and were born due to severe preeclampsia were enrolled as the observation group. Forty very preterm infants who were born to healthy mothers since uterine contractions could not be suppressed were enrolled as the control group. Perinatal features, clinical manifestations of infection, complications, and clinical outcomes were analyzed for the two groups. Results Within 6 hours and 2-3 days after birth, the observation group had significantly lower white blood cell count (WBC), absolute neutrophil count (ANC), and platelet count (PLT) than the control group (P < 0.05). At 5-7 days after birth, there was no significant difference in WBC between the two groups (P > 0.05), while the observation group still had significantly lower ANC and PLT than the control group (P < 0.05). The observation group had a significantly higher C-reactive protein (CRP) level than the control group at 2-3 days and 5-7 days after birth (P < 0.05). The observation group had a significantly higher proportion of infants with severe infections than the control group (P < 0.05). The observation group had a significantly higher hemoglobin level than the control group within 6 hours after birth (P < 0.05). The observation group had a significantly higher incidence rate of bronchopulmonary dysplasia than the control group (P < 0.05). There was no significant difference between the two groups in the rate of pulmonary hemorrhage, intracranial hemorrhage, neonatal necrotizing enterocolitis, retinopathy of prematurity, and the rate of use of invasive ventilation, and clinical outcomes (P > 0.05). Conclusions Very preterm small-for-gestational-age infants born due to severe preeclampsia have a high incidence rate of infection and severe conditions. Early manifestations include reductions in the infection indicators WBC, ANC, and PLT, and CRP does not increase significantly in the early stage and gradually increases at 2-3 days after birth. Most of these infants require invasive ventilation after birth, with bronchopulmonary dysplasia as the main complication. Clinical changes should be closely observed and inflammatory indicators should be monitored for early identification of infection, timely diagnosis, and timely adjustment of antibiotic treatment, so as to improve the outcome.

Key words

Severe eclampsia / Small-for-gestational-age infant / Leukopenia / Thrombocytopenia / Infection / Very preterm infant

Cite this article

Download Citations
LI Ting, ZHU Li-Min, ZHANG Yan-Ping, KONG Xiang-Yong, XU Hai-Bin. Clinical features of very preterm small-for-gestational-age infants born due to severe preeclampsia[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(3): 254-258 https://doi.org/10.7499/j.issn.1008-8830.2011006

References

[1] Cakir SC, Dorum BA, Koksal N, et al. The effects of maternal preeclampsia on inflammatory cytokines and clinical outcomes in premature infants[J]. Pak J Med Sci, 2020, 36(2):26-31.
[2] 关楚翘, 吴东亮. 重度妊娠高血压病对早产儿白细胞及凝血功能影响的研究[J]. 临床和实验医学杂志, 2015, 14(14):1164-1167.
[3] 张宏文, 张欣, 李星, 等. 重度妊娠高血压疾病对早产儿血液系统影响分析[J]. 中国实用儿科杂志, 2013, 28(1):48-51.
[4] Cetinkaya M, Ozkan H, Köksal N, et al. Neonatal outcomes of premature infants born to preeclamptic mothers[J]. J Matern Fetal Neonatal Med, 2010, 23(5):425-430.
[5] 刘梦南, 孙智勇. 新生儿呼吸窘迫综合征治疗进展[J]. 发育医学电子杂志, 2019, 7(1):24-26.
[6] 孔祥永, 董建英, 池婧涵, 等. 晚期早产儿中小于胎龄儿的临床特点[J]. 中国新生儿科杂志, 2012, 27(1):28-31.
[7] 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 5版. 北京:人民卫生出版社, 2019.
[8] Latini G, De Felice C, Giannuzzi R, et al. Survival rate and prevalence of bronchopulmonary dysplasia in extremely low birth weight infants[J]. Early Hum Dev, 2013, 89(Suppl 1):S69-S73.
[9] Horbar JD, Carpenter JH, Badger GJ, et al. Mortality and neonatal morbidity among infants 501 to 1500 grams from 2000 to 2009[J]. Pediatrics, 2012, 129(6):1019-1026.
[10] Schmutz N, Henry E, Jopling J, et al. Expected ranges for blood neutrophil concentrations of neonates:the Manroe and Mouzinho charts revisited[J]. J Perinatol, 2008, 28(4):275-281.
[11] Guillemette L, Lacroix M, Allard C, et al. Preeclampsia is associated with an increased pro-inflammatory profile in newborns[J]. J Reprod Immunol, 2015, 112:111-114.
[12] Okoye HC, Eweputanna LI, Korubo KI, et al. Effects of maternal hypertension on the neonatal haemogram in southern Nigeria:a case-control study[J]. Malawi Med J, 2016, 28(4):174-178.
[13] Machado FR, Salomão R, Rigato O, et al. Late recognition and illness severity are determinants of early death in severe septic patients[J]. Clinics (Sao Paulo), 2013, 68(5):586-591.
[14] Bhat YR, Cherian CS. Neonatal thrombocytopenia associated with maternal pregnancy induced hypertension[J]. Indian J Pediatr, 2008, 75(6):571-573.
[15] Tinsley JH, Chiasson VL, South S, et al. Immunosuppression improves blood pressure and endothelial function in a rat model of pregnancy-induced hypertension[J]. Am J Hypertens, 2009, 22(10):1107-1114.
[16] Moura MD, Margotto PR, Rugolo LM. Changes of blood flow in the umbilical artery in hypertensive pregnancy and the implications in the neonatal outcomes[J]. Rev Bras Ginecol Obstet, 2013, 35(2):71-77.
[17] 任丹, 李洪珍. 88例早产的相关因素及对母儿临床影响分析[J]. 中国地方病防治杂志, 2014, 29(S1):56.
[18] 冯周善, 吴繁, 贾春宏, 等. 超未成熟儿的临床救治情况[J]. 发育医学电子杂志, 2020, 8(1):60-66.
[19] Yang CC, Tang PL, Liu PY, et al. Maternal pregnancy-induced hypertension increases subsequent neonatal necrotizing enterocolitis risk:a nationwide population-based retrospective cohort study in Taiwan[J]. Medicine (Baltimore), 2018, 97(31):e11739.
[20] 廖正嫦, 岳少杰. 新生儿缺氧缺血综合征的研究进展[J]. 发育医学电子杂志, 2019, 7(1):19-23.
[21] Liu LY, Yang T, Ji J, et al. Integrating multiple ‘omics’ analyses identifies serological protein biomarkers for preeclampsia[J]. BMC Med, 2013, 11:236.
[22] 乔晓亮. 血清胱抑素C、超敏C反应蛋白和β2-微球蛋白水平变化对诊断妊娠高血压的临床意义[J]. 实验与检验医学, 2017, 35(2):241-242.

PDF(1377 KB)

Accesses

Citation

Detail

Sections
Recommended

/