Perinatal outcome of preterm infants born to severe pregnancy induced hypertension mothers with or without HELLP syndrome

Kim, Mi Jeong; Kim, Soo Yeong; Song, Eun Song; Choi, Young Youn; Kim, Yoon Ha; Song, Tae Bok

Abstract

PURPOSE:The aim of this study was to compare the perinatal outcome of preterm infants born to severe pregnancy induced hypertension (PIH) mothers according to the presence or absence of HELLP syndrome.
METHODS
A retrospective analysis was done in 314 premature live infants born to 302 severe PIH mothers who admitted at Chonnam National University Hospital from January 2002 to May 2008. Maternal and neonatal characteristics and their outcome were compared between the groups. Statistical analysis was performed by SPSS program using Student's t test, Chi-square analysis, Fisher's exact test, and logistic regression test.
RESULTS
Among 302 severe PIH mothers (single pregnancy 270, twin pregnancy 32), 84 (27.8%) were associated with HELLP syndrome. Among their 334 fetuses (singleton 270, twins 64), total 20 (6.0%) resulted in fetal death and the rate of fetal death was higher in HELLP syndrome group compared to the control group (12.2% vs. 3.4%, P=0.006). Among the 314 live premature infants, 86 (27.4%) were born to severe PIH with HELLP syndrome (study group) and 228 (72.6%) were born to the control group. There were no differences in maternal and neonatal characteristics, maternal death, neonatal morbidity and neonatal death between the groups. However, the duration of mechanical ventilation (12.2+/-14.5 vs. 7.6+/-9.9 days, P=0.019) and hospitalization (25.6+/-12.3 vs. 13.0+/-10.5 days, P=0.013) were longer in the study group.
CONCLUSION
Most of severe PIH mothers complicated by preterm birth, and especially combined with HELLP syndrome showed higher fetal and perinatal death than without HELLP syndrome. Moreover, their live-born premature infants needed longer duration of mechanical ventilation and hospitalization. These results indicate that careful fetal monitoring and delivery with the co-operations of obstetricians and neonatologists is essential to improve the perinatal outcome.