Short term outcomes of premature babies born to mothers with pregnancy induced hypertension at Rwanda military hospital (RMH) and Kigali university teaching hospital (CHUK)

Abstract

Background: Pregnancy-induced hypertension (PIH) is one of the most common diseases which complicate pregnancies and contribute to neonatal morbidity and mortality(1). Description of PIH effects on neonatal outcomes are various in different settings and their pattern is unknown in Rwanda.

Objectives: This study aimed to evaluate the effect of maternal PIH on neonatal morbidity and mortality in premature infants in comparison with preterm neonates born to mothers without PIH

Methods: Preterm neonates (<37 weeks gestational age(GA)) from mothers with PIH and those from mothers without PIH were evaluated prospectively and retrospectively at RMH and CHUK. SPSS 25, independent t-test, odds ratio and Chi-square were used for analysis.

Results: Hundred sixteen (116) neonates of mothers with PIH (group for study) and hundred sixteen (116) neonates of mothers without PIH (control of study) were enrolled. There was a significant difference between the study and control group with increased cesarean delivery (95.6% Vs 59.4%), small gestational age (58.8% Vs9.4%), gestational age (mean GA: 32.0±2.3 weeks Vs 30.9±2.9 weeks), decreased male sex (42.2% Vs 56.8%) and dexamethasone doses received (mean dose number: 1.5±1.4 Vs 1.9±1.4) with neonates born to mothers with PIH. There was a difference between two groups of study with a decrease of RDS(52.5% Vs 61.2%) increased NEC (10.3% Vs 5.1%) and primary hospital stay(31.0±28 days Vs22.7±18.2 days) in premature babies born at 32 weeks and earlier, lower neonatal sepsis (59.4% Vs 76.7%) and delayed time of death ( mean:31.0±28. days Vs 22.7±18.2days ) for neonates born to mothers with PIH. No difference was seen between the two groups in terms of ventilation, oxygenotheurapy duration, BPD, ROP, NEC, IVH, and jaundice.

Conclusions: This study showed that cesarean delivery rates, SGA, and GA were higher, dexamethasone doses received and male gender were lower for neonates born to mothers with PIH. Although no difference was found for mortality and other perinatal outcomes, neonates born to mothers with PIH had decreased RDS, increased NEC and prolonged primary hospital stay in premature babies born at 32 weeks and earlier, delayed death, and lower neonatal sepsis.