Maternal High Blood Pressure and Newborn's Blood Profile (MPIHHPN)

Romanian Society of Anesthesia and Intensive Care

Status: Completed

Conditions: Maternal-Fetal Exchange

Treatments: Other: AGA - Control group; Other: SGA-PIH Study group; Other: AGA-PIH Study group; Other: SGA - Control group

Study type: Observational

Funder types: Other

Identifiers

NCT03265704

201601MP

Details and patient eligibility

About

Maternal high blood pressure remodels the intrauterine environment of the fetus by altering hormonal and cellular signaling patterns and, as a result increases the risk of fetal and neonatal mortality and morbidity. Newborns of these mothers have an increased risk of intrauterine growth restriction, premature birth and hematological abnormalities, such as thrombocytopenia, polycythemia, and neutropenia. The purpose of the article is to review neonatal thrombocytopenia and neutropenia as a consequence of maternal high blood pressure and to establish the optimal management of these cases.

Full description

Pregnancy induced hypertension (PIH) and preeclampsia (preE) are caused by gestation and have an onset after 20 weeks of pregnancy. Although the exact etiology of PIH and preE remains unknown, two interconnected mechanisms have been identified to play an important role in the pathogenesis: dysfunction of the placental trophoblast and endothelial dysfunction within the maternal systemic vasculature. The endothelium has been identified as the target tissue of the disease. Endothelial alterations ultimately manifest as placental hypoxia and hypoplasia. The neonatal thrombocytopenia and neutropenia after pregnancy-induced hypertension is a result of inhibition of fetal bone marrow production of the myeloid lineage due to intrauterine hypoxic environment. This study aims to investigate the hematological profile in term and preterm infants born to mothers with preeclampsia. The current retrospective observational study was conducted at the Clinic of Obstetrics, Gynecology and Neonatology of the Emergency County Hospital, Timisoara over a period of three years, from January 2014 to December 2016. All inborn patient files were analyzed as anonymised limited data sets from archived records of the Neonatology Department.

Enrollment: 6,108 patients

Sex: All

Ages: 1 to 28 days old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age: 0-28 days
• Newborns of healthy mothers;
• Newborns of mothers with Pregnancy Induced Hypertension;
• Inborn Patients;
• Written Informed Consent signed by legal guardian.

Exclusion criteria

• Maternal disease other than PIH;
• Syndromal, chromosomal or infectious diseases of the newborns;
• Causes other then PIH for perinatal asphyxia.

Trial design

6,108 participants in 4 patient groups

AGA Neonates

Description:

AGA Control Group Appropriate for gestational age newborns of healthy mothers

Treatment:

Other: AGA - Control group

SGA Neonates

Description:

SGA - Control Group Small for gestational age newborns of healthy mothers

Treatment:

Other: SGA - Control group

AGA-PIH Neonates

Description:

AGA-PIH Study Group Appropriate for gestational age newborns of mothers with pregnancy induced hypertension

Treatment:

Other: AGA-PIH Study group

SGA-PIH Neonates

Description:

SGA-PIH Study Group Small for gestational age newborns of mothers with pregnancy induced hypertension

Treatment:

Other: SGA-PIH Study group