Melek BÜYÜKEREN, HASAN TOLGA ÇELİK, Gökçen ÖRGÜL, Şule YİĞİT, Mehmet Sinan BEKSAÇ, Murat YURDAKÖK

Neonatal outcomes of early- and late-onset preeclampsia

Background. The aim of the current study was to demonstrate the neonatal outcomes of infants born to mothers with early-onset preeclampsia (EP) and late-onset preeclampsia (LP), and compare the neonatal outcomes before and after 34 weeks of gestation in EP group. Methods. In this retrospective study, we evaluated preeclamptic mother and child pairs who were followed-up at Hacettepe University Hospital between the years 2010 and 2017. The pregnant women were classified as having EP if diagnosed before 34 weeks of gestation (n=91) and LP if diagnosed after 34 weeks of gestation (n=34). The women in the EP group were further divided into subgroups according to the gestational week at birth, including those who gave birth before 34 weeks of gestation (early birth; n=57) and after 34 weeks of gestation (late birth; n=34). Necessary clinical and demographic data were withdrawn from the electronic registry and patient files. Results. Neonates in the EP/late birth subgroup had significantly lower gestational age and birthweight. Small for gestational age (SGA) frequency was higher in the early-onset subgroup born after 34 weeks’ gestation compared to the late-onset preeclampsia group (p= 0,016). The incidence of neutropenia was significantly higher in the EP/late birth subgroup than in the LP group (p= 0.002). After correcting for gestational week and birth weight, neutrophil count was still significantly lower in the EP/late birth subgroup (p= 0.002). EP/late birth subgroup and LP group had comparable outcomes regardless of neutrophil count and SGA rate. Conclusions. Close follow up and postponing delivery in stable and appropriate pregnant women with preeclampsia would be beneficial for neonates.

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1.ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 2002; 77: 67-75.

2.Orhan HG, Ozgüneş H, Beksaç MS. Correlation between plasma malondialdehyde and ceruloplasmin activity values in preeclamptic pregnancies. Clin Biochem 2001; 34: 505-506.

3.Lisonkova S, Sabr Y, Mayer C, Young C, Skoll A, Joseph KS. Maternal morbidity associated with early-onset and late-onset preeclampsia. Obstet Gynecol 2014; 124: 771-781.

4.Ozcimen EE. New approaches for preeclampsia: review of the literature. Gynecol Obstet Reprod Med 2016; 21: 174-176.

5.Valensise H, Vasapollo B, Gagliardi G, Novelli GP. Early and late preeclampsia: two different maternal hemodynamic states in the latent phase of the disease. Hypertension 2008; 52: 873-880.

6.Stergiotou I, Crispi F, Valenzuela-Alcaraz B, Bijnens B, Gratacos E. Patterns of maternal vascular remodeling and responsiveness in early- versus late-onset preeclampsia. Am J Obstet Gynecol 2013; 209: 558.e1-558.e14.

7.Madazli R, Yuksel MA, Imamoglu M, et al. Comparison of clinical and perinatal outcomes in early- and late-onset preeclampsia. Arch Gynecol Obstet 2014; 290: 53-57.

8.Lambert G, Brichant JF, Hartstein G, Bonhomme V, Dewandre PY. Preeclampsia: an update. Acta Anaesthesiol Belg 2014; 65: 137-149.

9.Norwitz ER, Repke JT. Preeclampsia: Management and prognosis. UpToDate www.uptodate.com (Accessed: 20 April 2018).

10.Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol 2009; 33: 130-137.

11.Kilicci C, Yayla Abide C, Ozkaya E, et al. Confounders for Neonatal Intensive Care Unit admission in neonates of mothers with preeclampsia. Gynecol Obstet Reprod Med 2018; 24: 162-166.

12.Herzog EM, Eggink AJ, Reijnierse A, et al. Impact of early-and late-onset preeclampsia on features of placental and newborn vascular health. Placenta 2017; 49: 72-79.

13.Davis EF, Lazdam M, Lewandowski AJ, et al. Cardiovascular risk factors in children and young adults born to preeclamptic pregnancies: a systematic review. Pediatrics 2012; 129: e1552-e1561.

14.Proytcheva MA. Issues in neonatal cellular analysis. Am J Clin Pathol 2009; 131: 560-573.

15.Elgari MM, Khabour OF, Alhag SM. Correlations between changes in hematological indices of mothers with preeclampsia and umbilical cord blood of newborns. Clin Exp Hypertens 2019; 41: 58-61.

16.Herzog EM, Eggink AJ, van der Zee M, et al. The impact of early- and late-onset preeclampsia on umbilical cord blood cell populations. J Reprod Immunol 2016; 116: 81-85.

17.Ni Y, Cheng W. Comparison of indications of pregnancy termination and prognosis of mothers and neonates in early- and late-onset preeclampsia. Hypertens Pregnancy 2016; 35: 315-322.

18.Iacobelli S, Bonsante F, Robillard PY. Comparison of risk factors and perinatal outcomes in early onset and late onset preeclampsia: a cohort based study in Reunion Island. J Reprod Immunol 2017; 123: 12-16.

19.Nicolaides KH, Bilardo CM, Soothill PW, Campbell S. Absence of end diastolic frequencies in umbilical artery: a sign of fetal hypoxia and acidosis. BMJ 1988; 297: 1026-1027.

20.Manroe BL, Weinberg AG, Rosenfeld CR, Browne R. The neonatal blood count in health and disease. I. Reference values for neutrophilic cells. J Pediatr 1979; 95: 89-98.

21.Vogel JP, Chawanpaiboon S, Watananirun K, et al. Global, regional and national levels and trends of preterm birth rates for 1990 to 2014: protocol for development of World Health Organization estimates. Reprod Health 2016; 13: 76.

22.Carbillon L. High performance of maternal characteristics and assessment of uterine artery Doppler waveform for the prediction of early-onset preeclampsia. Am J Obstet Gynecol 2018; 218: 542.

23.Rawlings JS, Pettett G, Wiswell TE, Clapper J. Estimated blood volumes in polycythemic neonates as a function of birth weight. J Pediatr 1982; 101: 594-599.