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Preeclampsia May Compound Growth Restriction


 

PRAGUE — Preeclampsia may significantly worsen some perinatal outcomes in growth-restricted infants, according to a review of infants born to mothers with and without preeclampsia.

In a study of growth-restricted neonates born at a gestational age older than 24 weeks, 25 infants whose mothers had preeclampsia had significantly worse psychomotor development on the Ages and Stages Questionnaire than did 46 infants born to mothers who did not have preeclampsia, Dr. Elisenda Eixarch reported in a poster session at the 20th European Congress of Perinatal Medicine.

In those neurologic evaluations, which were prospectively evaluated at 24 months, the children born to preeclamptic mothers scored at a significantly lower centile on the fine motor and problem-solving dimensions than did children of nonpreeclamptic mothers. The other three dimensions of the questionnaire (communication, gross motor, and personal-social) were worse in children of mothers with preeclampsia than in those of mothers without preeclampsia but not significantly so, according to Dr. Eixarch of the department of obstetrics and gynecology at the Hospital Clinic, Barcelona.

All of the infants in the study were estimated to have a birth weight below the 10th percentile.

Dr. Eixarch and her colleagues adjusted the analysis of each dimension of the questionnaire for birth weight and gestational age, because those two variables were significantly higher among infants born to mothers without preeclampsia than among those born to mothers with preeclampsia.

Compared with infants born to nonpreeclamptic mothers, the babies who had preeclamptic mothers had significantly higher rates of cesarean section (36% vs. 70%) and “significant neonatal neurological morbidity” (3% vs. 13%)—that is, seizures, grade 2 or 3 intraventricular hemorrhage, or hypoxic encephalopathy—and a significantly longer length of stay in the neonatal ICU (5.4 days vs. 18.3 days).

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