75 - Association of Hypertensive Disorders of Pregnancy and Adverse Neonatal Outcomes among Infants 24-31 Weeks’ Gestation in China: A Multicenter Cohort Study

Poster Number: 75
Publication Number: 75.324

Jianfang Ge, Shanxi Children's Hospital, Taiyuan, Shanxi, China (People's Republic); Xinyue Gu, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Qin Zhou, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, Jiangsu, China (People's Republic); Ling Yang, Hainan Women and Children's Medical Center, HaiKou, Hainan, China (People's Republic); Yun Cao, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Wenhao Zhou, Children's Hospital, Shanghai, Shanghai, China (People's Republic); Yong Ji, Shanxi Children's Hospital, Taiyuan, Shanxi, China (People's Republic); Jianhua Sun, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China (People's Republic)

Background: The incidence of hypertensive disorders of pregnancy (HDP) in China has been reported to be higher than some other developed countries. As HDP is a risk factor for preterm birth, it may have adverse impacts on the outcomes of very preterm infants (VPI). However, there are few studies on the impact of HDP on outcomes of VPI in the Chinese population.

Objective: To describe the incidence of HDP among VPIs and to investigate the relationship between HDP and the outcomes of VPIs.

Design/Methods: We conducted a retrospective cohort study of VPIs born at gestational age of 24+0-31+6 weeks from January 1st to December 31st 2019 in the Chinese Neonatal Network (CHNN). We excluded infants with severe congenital anomalies or missing maternal HDP information. Two multivariate logistic regression models were generated with different groups of covariates to assess the association between HDP and neonatal outcomes. Subgroup analysis was done to compare infants born to mothers with or without preeclampsia/eclampsia.

Results: The incidence of HDP among VPIs in CHNN NICUs was 18.8%, and increased with increasing gestational age. There was no association between HDP and adverse neonatal outcomes (death, bronchopulmonary dysplasia, severe brain injury, severe retinopathy of prematurity (ROP), sepsis, necrotizing enterocolitis (NEC)) among VPIs overall based on the two models we generated. For extremely preterm infants (EPIs) at 24+0-27+6 weeks, the HDP group had lower odds of NEC (aOR 0.35, 95% CI 0.14 to 0.87 in model 2) and severe ROP (aOR 0.39, 95% CI 0.17 to 0.88 in model 1, aOR 0.27, 95% CI 0.09 to 0.83 in model 2) but higher odds of severe brain injury (aOR 1.67, 95% CI 1.04 to 2.67 in model 1).Conclusion(s): There was no significant association between HDP and adverse VPI overall. In a subgroup of EPIs, HDP was independently associated with decreased odds of NEC and severe ROP but increased odds of severe brain injury. Preeclampsia/eclampsia was associated with decreased odds of early death and severe ROP.
Table 1. Maternal Hypertensive Disorders of Pregnancy for Very Preterm Infants in China
Table 2. Neonatal outcomes of very preterm infants < 32 weeks born to non-HDP and HDP mothers