| Objective To study the relationship between hypertensive diseases in pregnancy and adverse outcomes of premature infants with birth weight<1500g,and to understand the influence of early treatment of hypertensive diseases in pregnancy on the outcomes of premature infants with birth weight<1500g.Methods A total of 189 preterm infants with birth weight<1500g admitted to neonatal intensive care unit from 2015 to 2019 were divided into gestational hypertensive disease group and non-gestational hypertensive disease group.In a case-control study,the relationship between pregnancy hypertension and adverse outcomes in premature infants with birth weight<1500g was analyzed by univariate Logistic regression analysis and then by multivariate Logistic regression analysis.Results 1.There was no significant difference in the baseline data（P>0.05）between the hypertensive disorder complicating pregnancy group and the without hypertensive disorder complicating pregnancy group in terms of sex,birth weight,Apgar score at 1,5,and 10 minutes after birth,vaginal delivery,neonatal hypothermia,initial blood acid-base status after birth,caffeine use after birth,maternal gestational diabetes,hypothyroidism during pregnancy,premature rupture of membranes,and prenatal dexamethasone（P>0.05）2.Hypertensive disorder complicating pregnancy was a risk factor for death of preterm infants with birth weight<1500g,and the risk was statistically significant（OR=1.545,95%CI:1.133-2.107,P=0.007）.Prenatal glucocorticoid therapy could reduce the risk of death of preterm infants with birth weight<1500g.There was statistical significance（OR=0.658,95%CI:0.436-0.992,P=0.046）.3.Hypertensive disorder complicating pregnancy was positively correlated with the incidence of some early adverse outcomes in children,including leukopenia（OR=2.962,95%CI:2.458-3.570,P=0.000）,thrombocytopenia（OR=1.695,95%CI:1.459-1.968）,P=0.000),neonatal hypoglycemia（OR=2.089,95%CI:1.838-2.374,P=0.000）,sepsis（OR=1.229,95%CI:1.062-1.421,P=0.006）,neonatal respiratory distress syndrome（OR=1.316,95%CI:1.154-1.500,P=0.000）,bronchopulmonary dysplasia（OR=1.206,95%CI:1.027-1.653,P=0.023）and necrotizing enterocolitis（OR=1.361,95%CI:1.121-1.653,P=0.002）.Meanwhile,the length of hospital stay was prolonged（β±S=2.778±0.376,P=0.013）,and both were statistically significant.Patent ductus arteriosus（OR=1.080,95%CI:0.876-1.331,P--0.473），retinopathy of prematurity（OR=1.223,95%CI:0.931-1.609,P=0.149）,and intraventricular hemorrhage（OR=0.922,95%CI:0.817-1.041,P=0.191）,there was no statistically significant difference.Prenatal use of glucocorticoids can reduce the occurrence of some early adrverse outcomes in mothers and children with hypertensive diseases during pregnancy,mainly including leukopenia（OR=0.765,95%CI:0.625-0.973,P=0.010）,thrombocytopenia（OR=0.431,95%CI:0.365-0.511,P=0.000）,neonatal hypoglycaemia（OR=0.817,95%CI:0.698-0.957,P=0.012）,neonatal respiratory distress syndrome（OR=0.759,95%CI:0.644-0.896,P=0.001）,patent ductus arteriosus（OR=0.302,95%CI:0.243-0.375,P=0.000）,intraventricular hemorrhage（OR=0.824,95%CI:0.706-0.960,P=0.013）,bronchopulmonary dysplasia（OR=0.627,95%CI:0.515-0.764,P=0.000）and retinopathy of prematurity（OR=0.309,95%CI:0.236-0.405,P=0.000）;However,it had little effect on reducing the incidence of sepsis（OR=0.850,95%CI:0.707-1.023,P=0.085）and necrotizing enterocolitis（OR=1.092,95%CI:0.856-1.393,P=0.477）.The length of hospital stay was not significantly reduced（β±S=-0.454±0.473,P=0.292）.4.Hypertensive disorder complicating pregnancy was negatively correlated with gross motor,fine motor,physical and human energy at corrected gestational age of 18 months for premature infants with birth weight<1500g,while prenatal glucocorticoid use was not significantly correlated with Gesell Developmental Scale scores.Conclusion Hypertensive disorder complicating pregnancy affects adverse outcomes in preterm infants with birth weight less than 1500g.Prenatal use of glucocorticoid can reduce adverse outcomes in the first trimester,but has no significant benefit in the long term. |
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