The condition of newborns and the course of the early neonatal period in children from mothers who had complications from the group of great obstetric syndromes
DOI:
https://doi.org/10.15574/SP.2024.140.18Keywords:
pregnancy, great obstetric syndromes, placental insufficiency, premature birth, preeclampsia, newborns, antenatal period, early neonatal periodAbstract
Aim of research - to study the peculiarities of the course of the antenatal and early postnatal period in children from mothers who had complications from the group of great obstetric syndromes (GOS), in order to improve the algorithm of their management.
Materials and methods. 239 newborns from pregnant women (the main group - MG) who had complications from the group of GOS, were examined. The control group (CG) consisted of newborns from 56 almost healthy pregnant women with a good reproductive history and an uncomplicated course of this pregnancy. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistical 6.0 programs.
Results. Newborns in the CG were significantly smaller in all anthropometric indicators compared to newborns in the CG, fetal growth restriction syndrome was observed in 41 (17.2%) newborns in the CG, while absent in CG. The condition of newborns according to the Apgar scale in 180 (75.3%) children of MG ranged from 5 to 7 points, >7 - in 59 (24.7%) (average value - 6.8±0.91), in CG - 7 ,9±0.73, at 5 minutes in 212 (88.7%) newborns >7 points. In the MG, 81 (33.9%) children were born in a state of asphyxia, which led to hypoxic-ischemic injury of the central nervous system in 54 (22.5%) newborns from mothers in the MG. Increased nerve excitability, small-scale tremor, horizontal nystagmus and low muscle tone were observed in 26 (10.8%) children, and generalized weakness - in 14 (5.9%) children from MG and 2 (3.6%) children from CG.
Conclusions. The conducted study showed that children born to mothers with clinical manifestations of GОS (premature birth, placental insufficiency, preeclampsia) have a high incidence of complications in the antenatal and early neonatal period, in particular, fetal growth restriction syndrome, distress in childbirth, asphyxia, hypoxic-ischemic injury to the central nervous system, conjugation jaundice, respiratory distress syndrome, as well as weight loss in newborns.
The research carried out in accordance with principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution indicated in the work. The informed consent of women was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Brosens I, Pijnenborg R, Vercruysse L, Romero R. (2011). The "Great obstetrical syndromes" are associated with disorders of deep placentation. Am J Obstet Gynecol. 204(3): 193-201. https://doi.org/10.1016/j.ajog.2010.08.009; PMid:21094932 PMCid:PMC3369813
Chaiworapongsa T, Romero R, Gotsch F et al. (2008). Low maternal concentrations of soluble vascular endothelial growth factor receptor-2 in preeclampsia and small for gestational age. J Matern Fetal Neonatal Medю 21(1): 41-52. https://doi.org/10.1080/14767050701831397; PMid:18175243 PMCid:PMC7062305
Di Renzo GC. (2008). The role of an ''anti-angiogenic state'' in complications of pregnancy. J Matern Fetal Neonatal Med. 21(1): 3-7. https://doi.org/10.1080/14767050701855081; PMid:18175240
Di Renzo GC. (2009). The Great Obstetrical Syndromes. The Journal of Maternal-Fetal & Neonatal Medicine. 22(8): 633-635. https://doi.org/10.1080/14767050902866804; PMid:19736613
Erez O, Romero R, Hoppensteadt D et al. (2008). Tissue factor and its natural inhibitor in preeclampsia and SGA. J Matern Fetal Neonatal Med. 21(12): 855-869. https://doi.org/10.1080/14767050802361872; PMid:19065458 PMCid:PMC3171292
Espinoza J, Chaiworapongsa T, Romero R et al. (2007). Unexplained fetal death: another anti- angiogenic state. J Matern Fetal Neonatal Med. 20(7): 495-507. https://doi.org/10.1080/14767050701413022; PMid:17674262 PMCid:PMC7062303
Espinoza J, Romero R, Nien JK et al. (2007). Identification of patients at risk for early onset and/or severe preeclampsia with the use of uterine artery Doppler velocimetry and placental growth factor. Am J Obstet Gynecol. 196(4): 326.e1-e13. https://doi.org/10.1016/j.ajog.2006.11.002; PMid:17403407 PMCid:PMC2190731
Gabbay-Benziv R, Baschat A. (2015). Gestational diabetes as one of the "great obstetrical syndromes" - the maternal, placental, and fetal dialog. Best Practice & Research Clinical Obstetrics & Gynaecology. 28(2): 150-155. https://doi.org/10.1016/j.bpobgyn.2014.04.025; PMid:25225057
Gordon A, Jeffery HE. (2008). Classification and description of stillbirths in New South Wales, 2002-2004. Med J Aust. 188(11): 645-648. https://doi.org/10.5694/j.1326-5377.2008.tb01822.x; PMid:18513173
HAPO Study Cooperative Research Group. (2009). Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: associations with neonatal anthropometrics. Diabetes. 58(2): 453-459. https://doi.org/10.2337/db08-1112; PMid:19011170 PMCid:PMC2628620
Kim YM, Bujold E, Chaiworapongsa T et al. (2013). Failure of physiologic transformation of the spiral arteries in patients with preterm labor and intact membranes. Am J Obstet Gynecol. 189(4): 1063-1069. https://doi.org/10.1067/S0002-9378(03)00838-X; PMid:14586356
Kim YM, Chaiworapongsa T, Gomez R et al. (2012). Failure of physiologic transformation of the spiral arteries in the placental bed in preterm premature rupture of membranes. Am J Obstet Gynecol. 187(5): 1137-1142. https://doi.org/10.1067/mob.2002.127720; PMid:12439491
Korteweg FJ, Gordijn SJ, Timmer A et al. (2008). A placental cause of intra-uterine fetal death depends on the perinatal mortality classification system used. Placenta. 29(1): 71-80. https://doi.org/10.1016/j.placenta.2007.07.003; PMid:17963842
Kusanovic JP, Romero R, Hassan SS et al. (2007). Maternal serum soluble CD30 is increased in normal pregnancy, but decreased in preeclampsia and small for gestational age pregnancies. J Matern Fetal Neonatal Med. 20(12): 867-878. https://doi.org/10.1080/14767050701482993; PMid:17853188 PMCid:PMC2276339
Metzger BE, Lowe LP, Dyer AR et al. (2008). Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 358(19): 1991-2002. https://doi.org/10.1056/NEJMoa0707943; PMid:18463375
Mintser AP. Statisticheskie metodyi issledovaniya v klinicheskoy meditsine. Prakticheskaya meditsina.2018; 3:41-45.
Ness RB, Sibai BM. (2006). Shared and disparate components of the pathophysiologies of fetal growth restriction and preeclampsia. Am J Obstet Gynecol. 195(1): 40-49. https://doi.org/10.1016/j.ajog.2005.07.049; PMid:16813742
Redman CW, Sargent IL. (2015). Latest advances in understanding preeclampsia. Science. 308(5728): 1592-1594. https://doi.org/10.1126/science.1111726; PMid:15947178
Roberts JM, Gammill HS. (2015). Preeclampsia: recent insights. Hypertension. 46(6): 1243-1249. https://doi.org/10.1161/01.HYP.0000188408.49896.c5; PMid:16230510
Romero R. (2009). Prenatal medicine: The child is the father of the man. J Matern Fetal Neonatal Med. 22(8): 636-639. https://doi.org/10.1080/14767050902784171; PMid:19736614
Romero R, Espinoza J, Gotsch F et al. (2006). The use of high-dimensional biology (genomics, transcriptomics, proteomics, and metabolomics) to understand the preterm parturition syndrome. BJOG. 113(3): 118-135. https://doi.org/10.1111/j.1471-0528.2006.01150.x; PMid:17206980 PMCid:PMC7062297
Romero R, Espinoza J, Mazor M, Chaiworapongsa T. (2004). The preterm parturition syndrome. In: Critchely H, Bennett P, Thornton S, editors. Preterm Birth. London: RCOG Press: 28-60.
Romero R, Mazor M, Munoz H et al. (1994). The preterm labor syndrome. Ann N Y Acad Sci. 734: 414-429. https://doi.org/10.1111/j.1749-6632.1994.tb21771.x; PMid:7978942
Romero R, Nien JK, Espinoza J et al. (2008). A longitudinal study of angiogenic (placental growth factor) and anti-angiogenic (soluble endoglin and soluble vascular endothelial growth factor receptor-1) factors in normal preg- nancy and patients destined to develop preeclampsia and deliver a small for gestational age neonate. J Matern Fetal Neonatal Med. 21(1): 9-23. https://doi.org/10.1080/14767050701830480; PMid:18175241 PMCid:PMC2587364
Sibai BM. (2004). Preeclampsia: an inflammatory syndrome? Am J Obstet Gynecol. 191(4): 1061-1062. https://doi.org/10.1016/j.ajog.2004.03.042; PMid:15507921
Sibai B, Dekker G, Kupferminc M. (2015). Preeclampsia. Lancet. 365(9461): 785-799. https://doi.org/10.1016/S0140-6736(05)71003-5
Soto E, Romero R, Kusanovic JP et al. (2012). Late-Onset Preeclampsia Is Associated with an Imbalance of Angiogenic and Anti-Angiogenic Factors in Patients with and without Placental Lesions Consistent with Maternal Underperfusion. The Journal of Maternal-Fetal & Neonatal Medicine. 25: 498-507. https://doi.org/10.3109/14767058.2011.591461; PMid:21867402 PMCid:PMC3401571
Stella CL, Sibai BM. (2016). Preeclampsia: Diagnosis and management of the atypical presentation. J Matern Fetal Neonatal Med. 19(7): 381-386. https://doi.org/10.1080/14767050600678337; PMid:16923692
Varli IH, Petersson K, Bottinga R et al. (2008). The Stockholm classification of stillbirth. Acta Obstet Gynecol Scand. 87(11): 1202-1212. https://doi.org/10.1080/00016340802460271; PMid:18951207
Yogev Y, Langer O. (2008). Pregnancy outcome in obese and morbidly obese gestational diabetic women. Eur J Obstet Gynecol Reprod Biol. 137(1): 21-26. https://doi.org/10.1016/j.ejogrb.2007.03.022; PMid:17517462
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Modern pediatrics. Ukraine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “MODERN PEDIATRICS. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
