Effect of Maternal Hypertension on Neonatal Outcome in Diyala Province, Iraq

Abstract

Background: Maternal hypertension and preeclampsia are a multisystem, highly variable disorder unique to pregnancy and a leading cause of maternal and fetal/neonatal morbidity and mortality. Given the progressive nature of the disorder, delivery is often necessary to minimize maternal morbidity and mortality; obstetricians must balance the need for achieving in utero fetal maturation with the maternal and fetal risks of continuing pregnancy.

Objectives: To evaluate the maternal burden and neonatal outcomes of infants delivered to mothers with preeclampsia, to review the outcomes of late-preterm infants, and potential strategies to optimize fetal outcomes in pregnancies complicated by preeclampsia.

Materials and Methods: A cohort prospective study done in Al-Batool Teaching Hospital for maternity and children from October 2011 to April 2012 for 55 mothers coming for antenatal follow up how hypertension and  preeclampsia had been followed till delivery with their delivered neonates looking for the maternal hypertension, medication, liver function, complete blood picture, complications of preeclampsia and neonatal condition at birth, weight, respiratory function, feeding, complete blood picture and liver function, small for gestational age (SGA), respiratory distress syndrome (RDS), and neonatal death (NND)  .

Results: Infants of women with preeclampsia were more likely to be SGA 27(49%) and have RDS 6 (10.1%); Frequency of preterm delivery at <37 weeks' gestation rose greatly with increasing severity of maternal hypertension 16 (29%). Fetal distress was seen in 12 cases (21.8%) with meconium staining of liquor in 8 cases 14.5%, 33 neonates (60%) required admission for many reasons. Mothers with hypertension have high risk of ante partum hemorrhage 40(72%), 17 delivered normally (30%) while 38 delivered by caesarean section (70%).

Conclusion: Compared with neonates delivered prematurely because of other etiologies, neonates born to preeclamptic mothers were more likely to be SGA and have less RDS, but had a decrease in mortality. This may be a reflection of the differences in the underlying pathophysiology behind indicated preterm birth due to preeclampsia