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

Andrea G. Witlin, George Saade, Farid Mattar, Baha M. Sibai

Research output: Contribution to journalArticle

118 Citations (Scopus)

Abstract

OBJECTIVE: We sought to characterize predictors of neonatal outcome in women with severe preeclampsia or eclampsia who were delivered of their infants preterm. STUDY DESIGN: We performed a retrospective analysis of 195 pregnancies delivered between 24 and 33 weeks' gestation because of severe preeclampsia or eclampsia. Multiple logistic regression and univariate χ2 analysis were performed for the dependent outcome variables of survival and respiratory distress syndrome by use of independent fetal and maternal variables. A P value of < .05 was considered significant. RESULTS: In the multivariate analysis, respiratory distress syndrome was inversely related to gestational age at delivery (P = .0018) and directly related to cesarean delivery (P = .02), whereas survival was directly related to birth weight (P = .00025). There was no correlation in the multivariate analysis between respiratory distress syndrome or survival and corticosteroid use, composite neonatal morbidity, mean arterial pressure, eclampsia, or abruptio placentae. In the univariate analysis respiratory distress syndrome was associated with cesarean delivery (odds ratio, 7.19; 95% confidence interval, 2.91-18.32). The incidence of intrauterine growth restriction increased as gestational age advanced. Furthermore, intrauterine growth restriction 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 affected survival independently of other variables. Presumed intrauterine stress, as reflected by the severity of maternal disease, did not improve neonatal outcome.

Original languageEnglish (US)
Pages (from-to)607-611
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume182
Issue number3
StatePublished - 2000

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Eclampsia
Pre-Eclampsia
Pregnancy
Survival
Odds Ratio
Confidence Intervals
Gestational Age
Multivariate Analysis
Growth
Mothers
Abruptio Placentae
Birth Weight
Premature Infants
Arterial Pressure
Adrenal Cortex Hormones
Logistic Models
Morbidity
Incidence

Keywords

  • Intrauterine growth restriction
  • Neonatal outcome
  • Preeclampsia

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Predictors of neonatal outcome in women with severe preeclampsia or eclampsia between 24 and 33 weeks' gestation. / Witlin, Andrea G.; Saade, George; Mattar, Farid; Sibai, Baha M.

In: American Journal of Obstetrics and Gynecology, Vol. 182, No. 3, 2000, p. 607-611.

Research output: Contribution to journalArticle

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