Correlation Between Early-onset Preeclampsia And Respiratory Distress Syndrome In Preterm Infants

Objective:To explore the relationship between early-onset preeclampsia(EOPE)and respiratory distress syndrome(RDS)in premature infants.Methods:Premature infants included in the study were born in Obstetrics and hospitalized in the Department of Neonatology in Fujian Maternal and Child Health Hospital from January 2019 to December 2020.The EOPE group were including 144 low birth weight premature infants whose mothers were diagnosed as EOPE.576 low birth weight premature infants whose mothers had normotension delivered at the same time were selected as the control group matched with the gestational age by the rate of1:4.The situation of occurrence,releted risk factors and outcome of RDS were compared between the two groups.According to the severity of preeclampsia,premature infants in the EOPE group were further divided into the early-onset severe preeclampsia(EOSR)group and the early-onset mild preeclampsia(EOMP)group.The effects of different degrees of EOPE on the incidence of RDS and other clinical outcomes of premature infants were compared.The correlation between EOPE and RDS in premature infants was investigated by logistic regression analysis.Results:1.A total of 720 premature infants with low birth weight were included in this study,including 144 premature infants of the EOPE group and 576 premature infants of the control group.The proportion of mean gestation age,elderly parturient women,obesity,cesarean section,asphyxia,small for gestational age infant,fetal distress in EOPE group were higher than those in control group,the differences were statistically significant(P<0.05);male and mean birth weight in EOPE group were lower than those in control group,and the differences were statistically significant(P<0.05).2.The proportion of RDS,pulmonary surfactant,septicemia,retinopathy of prematurity,necrotizing enterocolitis,patent ductus arteriosus in EOPE group were higher than those in control group,the differences were statistically significant(P<0.05);Premature rupture of membranes in EOPE group were lower than those in control group,and the differences were statistically significant(P<0.05).3.The correlation between EOPE and RDS in premature infants,and the correlation between EOPE and the severity of RDS in premature infants were investigated by multivariate Logistic regression.After adjusting for perinatal confounding factors such as gestational age and weight,the results showed that EOPE was a major risk factor for RDS,and the difference was statistically significant(P=0.009,OR=2.350,95%CI:1.240-4.452).EOPE was a major risk factor for severe RDS,and the difference was statistically significant(P=0.03,OR=7.199,95%CI:1.205-43.011).4.The EOPE group was divided into the EOSP group(103 cases)and the EOMP group(41 cases).RDS occurred in 32(31.1%)of 103 patients in the EOSP group and in 1(2.4%)of 41 patients in the EOMP group,there were significant differences(x~2=13.607,P<0.01).There was no significant difference in the proportion of severe RDS between the two groups(P>0.05).Multivariate Logistic regression was used to investigate the correlation between EOSP and RDS in preterm infants,the results showed that the risk of developing RDS in EOSP was higher than that in EOMP,and the difference was statistically significant(P=0.033,OR=15.619,95%CI:1.250-195.210).Conclusions:1.EOPE increases the mother’s risk of cesarean section and fetal distress,and the risk of asphyxia,small for gestational age,very low birth weight,extremely low birth weight,RDS,sepsis,retinopathy of prematurity,necrotizing enterocolitis,and patent ductus arteriosus in delivery of low birth weight premature infants,and neonatal boys are at higher risk in these cases.Therefore,in addition to strengthening maternal perinatal management,we should also attach great importance to the prevention and treatment of perinatal complications of premature infants to reduce the incidence of complications.2.EOPE is a major risk factor for RDS and severe RDS,and the risk of RDS in EOSP is higher than that in EOMP.It suggests that EOPE,especially EOSP,should be taken in prenatal and early birth to prevent NRDS in order to decrease the occurrence of severe RDS after birth.