Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy

Abstract To evaluate the impact of maternal hypertensive disorders of pregnancy (HDP) on mortality and neurological outcomes in extremely and very preterm infants using a nationwide neonatal database in Japan. This population-based retrospective study was based on an analysis of data collected by th...

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Autores principales:	Noriyuki Nakamura, Takafumi Ushida, Masahiro Nakatochi, Yumiko Kobayashi, Yoshinori Moriyama, Kenji Imai, Tomoko Nakano-Kobayashi, Masahiro Hayakawa, Hiroaki Kajiyama, Fumitaka Kikkawa, Tomomi Kotani, for the Neonatal Research Network of Japan
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a11594a083e74d2199dd67df9b1d2a1c
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spelling	oai:doaj.org-article:a11594a083e74d2199dd67df9b1d2a1c2021-12-02T13:56:48ZMortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy10.1038/s41598-021-81292-72045-2322https://doaj.org/article/a11594a083e74d2199dd67df9b1d2a1c2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81292-7https://doaj.org/toc/2045-2322Abstract To evaluate the impact of maternal hypertensive disorders of pregnancy (HDP) on mortality and neurological outcomes in extremely and very preterm infants using a nationwide neonatal database in Japan. This population-based retrospective study was based on an analysis of data collected by the Neonatal Research Network of Japan from 2003 to 2015 of neonates weighing 1,500 g or less at birth, between 22 and 31 weeks’ gestation. A total of 21,659 infants were randomly divided into two groups, HDP (n = 4,584) and non-HDP (n = 4,584), at a ratio of 1:1 after stratification by four factors including maternal age, parity, weeks of gestation, and year of delivery. Short-term (neonatal period) and medium-term (3 years of age) mortality and neurological outcomes were compared between the two groups by logistic regression analyses. In univariate analysis, HDP was associated with an increased risk for in-hospital death (crude odds ratio [OR], 1.31; 95% confidence interval, 1.04–1.63) and a decreased risk for severe intraventricular haemorrhage (0.68; 0.53–0.87) and periventricular leukomalacia (0.60; 0.48–0.77). In multivariate analysis, HDP was significantly associated with a lower risk for in-hospital death (adjusted OR, 0.61; 0.47–0.80), severe intraventricular haemorrhage (0.47; 0.35–0.63), periventricular leukomalacia (0.59; 0.45–0.78), neonatal seizures (0.40; 0.28–0.57) and cerebral palsy (0.70; 0.52–0.95) at 3 years after adjustment for covariates including birth weight. These results were consistent with those of additional analyses, which excluded cases with histological chorioamnionitis and which divided the infants into two subgroups (22–27 gestational weeks and 28–31 gestational weeks). Maternal HDP was associated with an increased risk for in-hospital death without adjusting for covariates, but it was also associated with a lower risk for mortality and adverse neurological outcomes in extremely and very preterm infants if all covariates except HDP were identical.Noriyuki NakamuraTakafumi UshidaMasahiro NakatochiYumiko KobayashiYoshinori MoriyamaKenji ImaiTomoko Nakano-KobayashiMasahiro HayakawaHiroaki KajiyamaFumitaka KikkawaTomomi Kotanifor the Neonatal Research Network of JapanNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Noriyuki Nakamura Takafumi Ushida Masahiro Nakatochi Yumiko Kobayashi Yoshinori Moriyama Kenji Imai Tomoko Nakano-Kobayashi Masahiro Hayakawa Hiroaki Kajiyama Fumitaka Kikkawa Tomomi Kotani for the Neonatal Research Network of Japan Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy
description	Abstract To evaluate the impact of maternal hypertensive disorders of pregnancy (HDP) on mortality and neurological outcomes in extremely and very preterm infants using a nationwide neonatal database in Japan. This population-based retrospective study was based on an analysis of data collected by the Neonatal Research Network of Japan from 2003 to 2015 of neonates weighing 1,500 g or less at birth, between 22 and 31 weeks’ gestation. A total of 21,659 infants were randomly divided into two groups, HDP (n = 4,584) and non-HDP (n = 4,584), at a ratio of 1:1 after stratification by four factors including maternal age, parity, weeks of gestation, and year of delivery. Short-term (neonatal period) and medium-term (3 years of age) mortality and neurological outcomes were compared between the two groups by logistic regression analyses. In univariate analysis, HDP was associated with an increased risk for in-hospital death (crude odds ratio [OR], 1.31; 95% confidence interval, 1.04–1.63) and a decreased risk for severe intraventricular haemorrhage (0.68; 0.53–0.87) and periventricular leukomalacia (0.60; 0.48–0.77). In multivariate analysis, HDP was significantly associated with a lower risk for in-hospital death (adjusted OR, 0.61; 0.47–0.80), severe intraventricular haemorrhage (0.47; 0.35–0.63), periventricular leukomalacia (0.59; 0.45–0.78), neonatal seizures (0.40; 0.28–0.57) and cerebral palsy (0.70; 0.52–0.95) at 3 years after adjustment for covariates including birth weight. These results were consistent with those of additional analyses, which excluded cases with histological chorioamnionitis and which divided the infants into two subgroups (22–27 gestational weeks and 28–31 gestational weeks). Maternal HDP was associated with an increased risk for in-hospital death without adjusting for covariates, but it was also associated with a lower risk for mortality and adverse neurological outcomes in extremely and very preterm infants if all covariates except HDP were identical.
format	article
author	Noriyuki Nakamura Takafumi Ushida Masahiro Nakatochi Yumiko Kobayashi Yoshinori Moriyama Kenji Imai Tomoko Nakano-Kobayashi Masahiro Hayakawa Hiroaki Kajiyama Fumitaka Kikkawa Tomomi Kotani for the Neonatal Research Network of Japan
author_facet	Noriyuki Nakamura Takafumi Ushida Masahiro Nakatochi Yumiko Kobayashi Yoshinori Moriyama Kenji Imai Tomoko Nakano-Kobayashi Masahiro Hayakawa Hiroaki Kajiyama Fumitaka Kikkawa Tomomi Kotani for the Neonatal Research Network of Japan
author_sort	Noriyuki Nakamura
title	Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy
title_short	Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy
title_full	Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy
title_fullStr	Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy
title_full_unstemmed	Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy
title_sort	mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/a11594a083e74d2199dd67df9b1d2a1c
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Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy

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