Is Maternal Hypertension a Reducing Factor for Intraventricular Hemorrhage in Iranian Preterm Newborns?

Background: Hypertensive disorders of pregnancy including preeclampsia can be associated with preterm birth and infant mortality and morbidity. It seems that intraventricular hemorrhage (IVH) in preterm neonates born to hypertensive mothers is less common compared to the other ones. In this study, we assessed the relationship between hypertensive disorders of pregnant mothers and the incidence of intraventricular hemorrhage in preterm neonates weighing less than ۱۵۰۰ grams. Methods: In this case-control study, ۳۰۵ singleton preterm neonates with a birth weight less than ۱۵۰۰ g were entered. The presence of IVH in all preterm neonates was assessed using brain ultrasonography and its correlation to hypertensive disorders of their mothers were evaluated. Results: The prevalence of preeclampsia in mothers with and without pre pregnancy hypertension was ۴۰%, and ۱۵.۰۹% respectively. The prevalence of IVH in preterm neonates was ۲۶.۹% (n=۸۲). The incidence of IVH in preterm neonates of mothers with and without preeclampsia was ۱۶.۰۷%, and ۲۹.۳۱%, respectively (p=۰.۰۲۸). The prevalence of IVH in preterm neonates of mothers with hypertension and without hypertension was ۱۲.۵% and ۲۹.۰۵%, respectively (p=۰.۰۱۸). Preterm neonates with IVH had a lower mean birth weight, smaller gestational age and lower Apgar scores compared to preterm neonates without IVH with p values of <۰.۰۰۱, <۰.۰۰۱ and <۰.۰۱, respectively. Conclusion: Hypertensive disorders of pregnancy increase the risk of preterm delivery, but the incidence of IVH in preterm neonates weighing less than ۱۵۰۰ gr is lower in infants born to mothers with hypertension including preeclampsia compared to those born to non-hypertensive mothers. And also lower gestational age, birth weight, and Apgar scores were important predicting factors for IVH in preterm neonates.

Keywords:

Preeclampsia , Maternal hypertension , Intraventricular hemorrhage , Prematurity , Newborn