Predictors of neonatal outcome in women with severe preeclampsia or eclampsia between 24 and 33 weeks' gestation

OBJECTIVE: We sought to characterize predictors of neonatal outcome in wome n with severe preeclampsia or eclampsia who were delivered of their infants preterm. STUDY DESIGN: We performed a retrospective analysis of 195 pregnancies deli vered between 24 and 33 weeks' gestation because of severe preeclampsia or eclampsia. Multiple logistic regression and univariate chi(2) analysis were performed for the dependent outcome variables of survival and respiratory distress syndrome by use of independent fetal and maternal variables. A P v alue of <.05 was considered significant. RESULTS: In the multivariate analysis, respiratory distress syndrome was in versely related to gestational age at delivery (P =.0018) and directly rela ted to cesarean delivery (P =.02), whereas survival was directly related to birth weight (P =.00025). There was no correlation in the multivariate ana lysis between respiratory distress syndrome or survival and corticosteroid use, composite neonatal morbidity, mean arterial pressure, eclampsia, or ab ruptio placentas. In the univariate analysis respiratory distress syndrome was associated with cesarean delivery (odds ratio, 7.19; 95% confidence int erval, 2.91-18.32). The incidence of intrauterine growth restriction increa sed as gestational age advanced. Furthermore, intrauterine growth restricti on decreased survival in both the multivariate (P =.038; odds ratio, 13.2; 95% confidence interval, 1.16-151.8) and univariate (P =.001; odds ratio, 5 .88; 95% confidence interval, 1.81-19.26) analyses. CONCLUSION: The presence of intrauterine growth restriction adversely affec ted survival independently of other variables. Presumed intrauterine stress , as reflected by the severity of maternal disease, did not improve neonata l outcome.