Effect of hypertensive disorders in pregnancy on neonatal outcome in growth restricted fetuses

Objective: To determine the effect of hypertensive disorders in pregnancy o n the neonatal outcome of growth restricted fetuses. There is conflicting d ata on the effect of hypertension during pregnancy on the incidence of neon atal respiratory distress syndrome (RDS) and intraventricular hemorrhage. S ome studies report a lower incidence of RDS and intraventricular hemorrhage in infants of hypertensive mothers, whereas other studies report a similar or higher incidence in infants born to hypertensive mothers. Study design: We performed a retrospective analysis of 220 growth restricte d fetuses born between January 1, 1996 to July 1, 1997 at the Department of Obstetrics and Gynecology of the University-Hospital at Homburg/Saar. Data were obtained by review of the medical records. Growth restricted infants born to preeclamptic women or women with HELLP syndrome were compared to gr owth restricted fetuses born to mothers without hypertensive disorders. Results: Growth restricted fetuses born to hypertensive mothers had a signi ficant lower birth weight (p < 0.05). The incidence of RDS in children born to hypertensive mothers was significantly higher (p < 0.05, p < 0.01) and they stayed significantly longer in the neonatal intensive care unit (p < 0 .01). In contrast to infants born to mothers with HELLP syndrome (n = 7) th ere was no difference in the incidence of intraventricular hemorrhage, infe ction, sepsis, necrotizing enterocolitis or cardiac complications (arrhythm ia, insufficiency) in case of preeclampsia (n = 68). The perinatal mortalit y of infants born to hypertensive mothers was significantly higher (p < 0.0 5, p < 0.01). Conclusion: This study does not support the contention that hypertensive di sorders in pregnancy have a beneficial effect on the postnatal course of IU GR infants.