Pregnancy Outcomes of Severe Preeclampsia Premature Birth and Spontaneous Premature Birth: A Case-Control Study_Chinese Journal of Evidence-Based Medicine

Authors：

LI Zejun ,  LIU Xinghui , HE Guolin , ZHANG Shuo

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LIU Xinghui, Email: dorislize19@163.com

Keywords：

Severe preeclampsia; Spontaneous premature birth; Pregnancy outcome

DOI：

10.7507/1672-2531.20100537

Video：

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Objective 　To explore the maternal and neonatal outcomes of different types of severe preeclampsia premature birth.
Methods 　The pregnant outcomes of 142 patients with severe preeclampsia premature birth (the study group) were compared with 311 patients with spontaneous premature birth (the control group). Singleton pregnancy was divided into three stages by gestational age: very early premature birth (28-31+6 weeks), moderate premature birth (34-36+6 weeks) and mild premature birth (32-33+6 weeks). Multiple-pregnancy was divided into two stages: lt;34 weeks of gestation group and ≥34 weeks of gestation group.
Results 　he rates of antenatal care and the average birth weight of trial group were much lower than those of control group. he rates of cesarean delivery and complications of trial group were much higher than those of control group. he total neonatal mortality and neonatal intensive care unit (NICU) hospitalization rate of singleton pregnancy in trial group was much higher than that of control group (P lt;0.05). In very early premature birth, neonatal outcomes were particularly bad, but there was no diference between trial group and control group. In moderate premature birth and mild premature birth, the incidences of neonatal pneumonia and the aspiration syndrome of trial group were higher than those of control group, and the duration of NICU hospitalization was longer in trial group than in control group. he incidences of heart failure and postpartum hemorrhage in twin pregnancy combined with severe preeclampsia were particularly high.
Conclusion 　Severe preeclampsia signiicantly afects fetal growth and perinatal outcomes; the average birth weight in each trial group of singleton pregnancy is much lower than that of control group. In moderate premature birth and mild premature birth, the neonatal adverse outcomes of trial group are much higher than those of control group. he total neonatal mortality and NICU hospitalization rate of singleton pregnancy in trial group is much higher than that of control group. In very early premature birth, morbidity and mortality of the newborn is closely related to gestational age. Women of multiple-pregnancy complicated with severe preeclampsia require more concerns about health care in order to prevent heart failure and postpartum hemorrhage.

Citation： LI Zejun,LIU Xinghui,HE Guolin,ZHANG Shuo. Pregnancy Outcomes of Severe Preeclampsia Premature Birth and Spontaneous Premature Birth: A Case-Control Study. Chinese Journal of Evidence-Based Medicine, 2010, 10(9): 1016-1022. doi: 10.7507/1672-2531.20100537 Copy

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2.	Sibai BM. Diagnosis and management of gestational hypertension-preeclampsia. Obstet Gynecol, 2003,102: 181-192.
3.	Sibai BM, Dekker G, Kupferminc M. Pre-eclampsia. Lancet, 2005, 365: 785-799.
4.	严小丽, 张力, 刘兴会, 等. 重度子痫前期终止妊娠时机探讨. 中国妇产科临床杂志, 2006, (6): 414-417.
5.	石凌懿, 杨孜, 郭艳军, 等. 重度子痫前期早产与自发性早产临床对比分析. 实用妇产科杂志, 2005, 21(11): 663-667.
6.	Cunningham FG, Leweno KJ, Bloom SL, et al. Williams Obstetrics. 22nd ed. New York: Mc Graw-Hill Companics Inc, 2005: 761-764.
7.	Meis PJ, Michielutte R, Peters TJ, et al. Factors associated with preterm birth in Cardif, Wales.Ⅱ. Indicated and spontaneous preterm birth. Am J Obstet Gynecol, 1995, 73(2): 597-602.
8.	Owen J, Baker SL Hauth JC, et al. Is indicated or spontaneous preterm delivery more advantageous for the fetus? Am J Obstet Gynecol, 1990, 163 (3): 868-872.
9.	万淑梅, 余艳红, 黄莺莺, 等. 妊娠期高血压疾病严重并发症的发生规律及其对母儿的影响. 中华妇产科杂志, 2007, 42(8): 510-514.
10.	胡昭怡. 2000~2008年重度子痫前期常见并发症流行病学调查分析. 中国妇幼保健, 2009, 24(33): 4710-4711.

1. Sibai BM. Preeclampsia as a cause of reterm and late preterm (nearterm) Births. Seminaris in Perinatology, 2006, 30: 16-19.
2. Sibai BM. Diagnosis and management of gestational hypertension-preeclampsia. Obstet Gynecol, 2003,102: 181-192.
3. Sibai BM, Dekker G, Kupferminc M. Pre-eclampsia. Lancet, 2005, 365: 785-799.
4. 严小丽, 张力, 刘兴会, 等. 重度子痫前期终止妊娠时机探讨. 中国妇产科临床杂志, 2006, (6): 414-417.
5. 石凌懿, 杨孜, 郭艳军, 等. 重度子痫前期早产与自发性早产临床对比分析. 实用妇产科杂志, 2005, 21(11): 663-667.
6. Cunningham FG, Leweno KJ, Bloom SL, et al. Williams Obstetrics. 22nd ed. New York: Mc Graw-Hill Companics Inc, 2005: 761-764.
7. Meis PJ, Michielutte R, Peters TJ, et al. Factors associated with preterm birth in Cardif, Wales.Ⅱ. Indicated and spontaneous preterm birth. Am J Obstet Gynecol, 1995, 73(2): 597-602.
8. Owen J, Baker SL Hauth JC, et al. Is indicated or spontaneous preterm delivery more advantageous for the fetus? Am J Obstet Gynecol, 1990, 163 (3): 868-872.
9. 万淑梅, 余艳红, 黄莺莺, 等. 妊娠期高血压疾病严重并发症的发生规律及其对母儿的影响. 中华妇产科杂志, 2007, 42(8): 510-514.
10. 胡昭怡. 2000~2008年重度子痫前期常见并发症流行病学调查分析. 中国妇幼保健, 2009, 24(33): 4710-4711.

Chinese Journal of Evidence-Based Medicine

Pregnancy Outcomes of Severe Preeclampsia Premature Birth and Spontaneous Premature Birth: A Case-Control Study

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