Yıl 2020, Cilt 20 , Sayı 3, Sayfalar 100 - 106 2020-12-29

Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia
Erken ve Geç Başlangıçlı Preeklampside Risk Faktörleri ve Neonatal Sonuçların Karşılaştırılması

Özgül BULUT [1] , Meryem HOCAOĞLU [2] , Nurgül BULUT [3] , Selin DEMİRER [4] , Abdulkadir TURGUT [5] , Fahri OVALI [6]


Objective: To compare the maternal risk factors and early neonatal outcomes in early-onset and late-onset preeclampsia. Material and Methods: In our hospital, patients diagnosed with preeclampsia were evaluated retrospectively. The patients were divided into two groups as early onset preeclampsia (≤34 weeks) and late onset preeclampsia (>34 weeks). Statistical analyses were used to compare demographic data, maternal risk factors and neonatal outcomes between the two groups. Results: Out of 92 patients, 45 (49%) were in the early onset preeclampsia and 47 (51%) were in the late onset preeclampsia groups. Cesarean delivery and intrauterine growth retardation (IUGR) rates were significantly higher in the early onset preeclampsia group (p=0.01, p=0.025). High body mass index was an independent risk factor for late onset preeclampsia in the logistic regression analysis (p=0.012). Neonatal morbidities and hospitalization rates in the neonatal intensive care unit (NICU) were significantly higher in the early onset preeclampsia group (p<0.05, p=0.005, respectively). In addition, in the logistic regression analysis, it was found that early onset preeclampsia significantly increased the risks of IUGR (OR 2.96; 95% CL: 1.12–7.81), being small for gestational age (OR 2.5; 95% CL: 1.05–5.95), respiratory distress syndrome (OR 15.35; 95% CL: 3.06–76.99), patent ductus arteriosus (OR 11.43; 95% CL: 1.36–96.16) and hospitalization in the NICU (OR 2.48; 95% CL: 1.06–5.77). Conclusion: Early-onset preeclampsia was found to be an important risk factor for adverse neonatal outcomes while high body mass index during pregnancy was associated with late-onset preeclampsia.
Amaç: Erken başlangıçlı ve geç başlangıçlı preeklampside maternal risk faktörleri ve erken dönem neonatal sonuçların karşılaştırılması. Gereç ve Yöntem: Hastanemizde preeklampsi tanısı almış hastalar retrospektif olarak değerlendirildi. Hastalar erken başlangıçlı preeklampsi (≤34 hafta) ve geç başlangıçlı preeklampsi (>34 hafta) olmak üzere 2 gruba ayrıldı. İki grup arasında demografik data, maternal risk faktörleri ve neonatal sonuçları karşılaştırmak için istatistiksel analiz yapıldı. Bulgular: Preeklampsi tanısı alan 92 hastanın, 45 (%49)’i erken başlangıçlı preeklampsi ve 47 (%51)’si geç başlangıçlı preeklampsi idi. Erken başlangıçlı preeklampsi grubunda, sezaryen doğum ve intrauterin büyüme kısıtlılığı (İUBK) oranları anlamlı şekilde daha yüksek bulundu (p=0.01, p=0.025). Lojistik regresyon analizinde, gebelikte yüksek vücut kitle indeksinin geç başlangıçlı preeklampsi için bağımsız bir risk faktörü olduğu saptandı (p=0.012). Erken başlangıçlı preeklampsi grubunda, neonatal morbidite ve yenidoğan yoğun bakım ünitesine (YDYBÜ) yatış oranları anlamlı şekilde daha yüksek bulundu (p<0.05, p=0.005, sırasıyla). Bunun yanında, lojistik regresyon analizinde erken başlangıçlı preeklampsinin, İUBK (OR 2.96; 95% CL: 1.12–7.81), SGA (OR 2.5; 95% CL: 1.05–5.95), respiratuar distres sendromu (OR 15.34; 95% CL: 3.06–76.99), patent duktus arteriosus (OR 11.43; 95% CL: 1.36–96.16) ve YDYBÜ’ne yatış (OR 2.48; 95% CL: 1.06–5.77) riskini anlamlı şekilde artırdığı saptandı. Sonuç: Çalışmamızda, erken başlangıçlı preeklampsi, olumsuz neonatal sonuçlar için önemli bir risk faktörü olarak bulunurken, gebelikte yüksek vücut kitle indeksi geç başlangıçlı preeklampsi ile ilişkili bulundu.
  • 1. Monteith C, Egan K, O’Connor H, Maguire P, Kevane B, Szklanna PB, et al. Early-onset preeclampsia is associated with an elevated mean platelet volume (MPV) and a greater rise in MPV from time of booking compared with pregnant controls: results of the CAPE study. J Perinat Med 2018;46(9):1010-15. https://doi.org/ 10.1515/ jpm-2017-0188.
  • 2. American College of Obstetricians and Gynecologists. Practice Bulletin No. 202: gestational hypertension and preeclampsia. Obstet Gynecol 2019;133(1):1-25. https://doi.org/10.1097/AOG.0000000000003018.
  • 3. Machado JSR, Machado MSR, Bertagnolli TV, Martins LAB, Freitas SF, Ovidio PP, et al. Role of plasma PlGF, PDGF-AA, ANG-1, ANG- 2, and the ANG-1/ANG-2 ratio as predictors of preeclampsia in a cohort of pregnant women. Pregnancy Hypertens 2019;16:105- 111. https://doi:10.1016/j.preghy.2019.03.011.
  • 4. Staff AC. The two-stage placental model of preeclampsia: An update. J Reprod Immunol 2019;134-135:1-10. https:// doi:10.1016/j.jri.2019.07.00.
  • 5. Burton GJ, Redman CW, Roberts JM, Moffett A. Pre-eclampsia: pathophysiology and clinical implications. BMJ 2019;366:l2381. https://doi.org/10.1136/bmj.l2381.
  • 6. Kucukbas GN, Sanhal CY, Uygur D. Plasma endocan levels in early and late-onset preeclampsia. Fetal Pediatr Pathol 2019;1-8. https://doi.org/10.1080/15513815.2019.1693674.
  • 7. Ni Y, Cheng W. Comparison of indications of pregnancy termination and prognosis of mothers and neonates in early- and late-onset preeclampsia. Hypertens Pregnancy 2016; 35(3): 315-22. https:// doi.org/10.3109/10641955.2016.1143486.
  • 8. Publications Committee, Society for Maternal-Fetal Medicine, Sibai BM. Evaluation and management of severe preeclampsia before 34 weeks’ gestation. Am J Obstet Gynecol 2011;205(3):191-198. https://doi.org/10.1016/j.ajog.2011.07.017.
  • 9. Pettit F, Mangos G, Davis G, Henry A, Brown MA. Pre-eclampsia causes adverse maternal outcomes across the gestational spectrum. Pregnancy Hypertens 2015;5(2):198-204. https://doi. org/10.1016/j.preghy.2015.02.002
  • 10. Wójtowicz A, Zembala-Szczerba M, Babczyk D, Kołodziejczyk- Pietruszka M, Lewaczyńska O, Huras H.et al. Early- and late-onset preeclampsia: a comprehensive cohort study of laboratory and clinical findings according to the New ISHHP Criteria. Int J Hypertens 2019;2019:4108271. https://doi.org/10.1155/2019/4108271.
  • 11. Weitzner O, Yagur Y, Weissbach T, Man El G, Biron-Shental T. Preeclampsia: risk factors and neonatal outcomes associated with early- versus late-onset diseases. J Matern Fetal Neonatal Med 2020;33(5):780-84. https://doi.org/10.1080/14767058.2018.150 0551.
  • 12. Gruslin A, Lemyre B. Pre-eclampsia: fetal assessment and neonatal outcomes. Best Pract Res Clin Obstet Gynaecol 2011;25(4):491- 507. https://doi.org/10.1016/j.bpobgyn.2011.02.004.
  • 13. Lisonkova S, Joseph KS. Incidence of preeclampsia: risk factors and outcomes associated with early- versus late-onset disease. 2013;209(6):544.e1-544.e12. https://doi:10.1016/j. ajog.2013.08.019
  • 14. Madazli R, Yuksel MA, Imamoglu M, et al. Comparison of clinical and perinatal outcomes in early- and late-onset preeclampsia. Arch Gynecol Obstet 2014;290(1):53-57. https://doi.org/10.1007/ s00404-014-3176-x.
  • 15. Soliman Y, Alshaikh B, Alawad E, Akierman A, Elsharkawy A, Yusuf K. Respiratory outcomes of late preterm infants of mothers with early and late-onset preeclampsia. J Perinatol 2020;40(1):39-45. https://doi.org/10.1038/s41372-019-0497-4.
  • 16. Orgeig S, Crittenden TA, Marchant C, McMillen IC, Morrison JL. Intrauterine growth restriction delays surfactant protein maturation in the sheep fetus. Am J Physiol Lung Cell Mol Physiol 2010;298(4):575-83. https://doi.org/10.1152/ajplung.00226.2009.
  • 17. Chaiworapongsa T, Chaemsaithong P, Yeo L, Romero R. Preeclampsia part 1: current understanding of its pathophysiology. Nat Rev Nephrol 2014;10(8):466-80. https://doi.org/10.1038/ nrneph.2014.102.
  • 18. Wang A, Holston AM, Yu KF, Zhang J, Toporsian M, Karumanchi SA, et al. Circulating anti-angiogenic factors during hypertensive pregnancy and increased risk of respiratory distress syndrome in preterm neonates. J Matern Fetal Neonatal Med 2012;25(8):1447- 52. https://doi.org/10.3109/14767058.2011.640368.
  • 19. Simchen MJ, Beiner ME, Strauss-Liviathan N, Dulitzky M, Kuint J, Mashiach S, et al. Neonatal outcome in growth-restricted versus appropriately grown preterm infants. Am J Perinatol 2000;17(4):187-92. https://doi.org/10.1055/s-2000-9423.
  • 20. Bányász I, Bokodi G, Vásárhelyi B, Treszl A, Derzbach L, Szabó A, et al. Genetic polymorphisms for vascular endothelial growth factor in perinatal complications. Eur Cytokine Netw 2006;17:266-70. https://doi.org/10.1684/ecn.2006.0041.
  • 21. Withagen MI, Visser W, Wallenburg HC. Neonatal outcome of temporizing treatment in early-onset preeclampsia. Eur J Obstet Gynecol Reprod Biol 2001;94(2):211-5. https://doi.org/10.1016/ s0301-2115(00)00332-8.
  • 22. Shah DM, Shenai JP, Vaughn WK. Neonatal outcome of premature infants of mothers with preeclampsia. J Perinatol 1995;15(4):264-7.
  • 23. Hamrick SE, Hansmann G. Patent ductus arteriosus of the preterm infant. Pediatrics 2010;125(5):1020-30. https://doi.org/10.1542/ peds.2009-3506
  • 24. Teramo KA, Widness JA. Increased fetal plasma and amniotic fluid erythropoietin concentrations: markers of intrauterine hypoxia. Neonatology 2009;95(2):105-16. https://doi.org/10.1159/000153094.
  • 25. Park YH, Lee GM, Yoon JM, Cheon EJ, Ko KO, Lee YH, et al. Effect of early postnatal neutropenia in very low birth weight infants born to mothers with pregnancy-induced hypertension. Korean J Pediatr 2012;55(12):462-9. https://doi.org/10.3345/kjp.2012.55.12.462.
  • 26. Akbar AMI, Herdiyantini M, Aryananda RA, CIninta N, Wardhana MP, Gumilar KE, et al. Serum heme oxygenase 1 (HO-1), soluble FMS like tyrosine kinase (sFlt-1) level, and neonatal outcome in early-onset, late-onset preeclampsia, and normal pregnancy. Hypertens Pregnancy 2018;37(4):175-81. https://doi.org/10.10 80/10641955.2018.1494187.
  • 27. Kucukgoz GU, Ozgunen FT, Buyukkurt S, Guzel AB, Urunsak IF, Demir SC, et al. Comparison of clinical and laboratory findings in early- and late-onset preeclampsia. J Matern Fetal Neonatal Med 2013;26(12):1228-33. https://doi.org/10.3109/14767058.2013.7 76533.
  • 28. Poorolajal J, Jenabi E. The association between body mass index and preeclampsia: a meta-analysis. J Matern Fetal Neonatal Med 2016;29(22):3670-6. https://doi.org/10.3109/14767058.2016.11 40738.
  • 29. Roberts JM, Redman CWG, Global Pregnancy Collaboration. Global Pregnancy Collaboration symposium: prepregnancy and very early pregnancy antecedents of adverse pregnancy outcomes: overview and recommendations. Placenta 2017;60:103-109. https://doi. org/10.1016/j.placenta.2017.07.012.
  • 30. O’Brien TE, Ray JG, Chan WS. Maternal body mass index and the risk of preeclampsia: a systematic overview. Epidemiology 2003;14(3):368-74. https://doi.org/10.1097/00001648- 200305000-00020
  • 31. Ornaghi S, Tyurmorezova A, Algeri P, Giardini V, Ceruti P, Vertemati E, et al. Influencing factors for late-onset preeclampsia. J Matern Fetal Neonatal Med 2013;26(13):1299-302. https://doi.org/10.31 09/14767058.2013.783807.
Birincil Dil en
Konular Pediatri
Bölüm Araştırma Makaleleri
Yazarlar

Orcid: 0000-0001-9939-7375
Yazar: Özgül BULUT (Sorumlu Yazar)
Kurum: Department of Pediatrics, Division of Neonatology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul
Ülke: Turkey


Orcid: 0000-0002-1832-9993
Yazar: Meryem HOCAOĞLU
Kurum: Department of Obstetrics and Gynecology Clinic, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul
Ülke: Turkey


Orcid: 0000-0002-7247-6302
Yazar: Nurgül BULUT
Kurum: Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul
Ülke: Turkey


Orcid: 0000-0002-5888-0835
Yazar: Selin DEMİRER
Kurum: Department of Genetics, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul
Ülke: Turkey


Orcid: 0000-0002-3156-2116
Yazar: Abdulkadir TURGUT
Kurum: Department of Obstetrics and Gynecology Clinic, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul
Ülke: Turkey


Orcid: 0000-0002-9717-313X
Yazar: Fahri OVALI
Kurum: Department of Pediatrics, Division of Neonatology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 29 Aralık 2020

Bibtex @araştırma makalesi { jchild809801, journal = {Çocuk Dergisi}, issn = {}, eissn = {1308-8491}, address = {Çocuk Dergisi Yayın Kurulu Sekreterliği İstanbul Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı Çapa, 34390, İstanbul}, publisher = {İstanbul Üniversitesi}, year = {2020}, volume = {20}, pages = {100 - 106}, doi = {}, title = {Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia}, key = {cite}, author = {Bulut, Özgül and Hocaoğlu, Meryem and Bulut, Nurgül and Demi̇rer, Selin and Turgut, Abdulkadir and Ovalı, Fahri} }
APA Bulut, Ö , Hocaoğlu, M , Bulut, N , Demi̇rer, S , Turgut, A , Ovalı, F . (2020). Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia . Çocuk Dergisi , 20 (3) , 100-106 . Retrieved from https://dergipark.org.tr/tr/pub/jchild/issue/58892/809801
MLA Bulut, Ö , Hocaoğlu, M , Bulut, N , Demi̇rer, S , Turgut, A , Ovalı, F . "Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia" . Çocuk Dergisi 20 (2020 ): 100-106 <https://dergipark.org.tr/tr/pub/jchild/issue/58892/809801>
Chicago Bulut, Ö , Hocaoğlu, M , Bulut, N , Demi̇rer, S , Turgut, A , Ovalı, F . "Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia". Çocuk Dergisi 20 (2020 ): 100-106
RIS TY - JOUR T1 - Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia AU - Özgül Bulut , Meryem Hocaoğlu , Nurgül Bulut , Selin Demi̇rer , Abdulkadir Turgut , Fahri Ovalı Y1 - 2020 PY - 2020 N1 - DO - T2 - Çocuk Dergisi JF - Journal JO - JOR SP - 100 EP - 106 VL - 20 IS - 3 SN - -1308-8491 M3 - UR - Y2 - 2020 ER -
EndNote %0 Çocuk Dergisi Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia %A Özgül Bulut , Meryem Hocaoğlu , Nurgül Bulut , Selin Demi̇rer , Abdulkadir Turgut , Fahri Ovalı %T Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia %D 2020 %J Çocuk Dergisi %P -1308-8491 %V 20 %N 3 %R %U
ISNAD Bulut, Özgül , Hocaoğlu, Meryem , Bulut, Nurgül , Demi̇rer, Selin , Turgut, Abdulkadir , Ovalı, Fahri . "Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia". Çocuk Dergisi 20 / 3 (Aralık 2020): 100-106 .
AMA Bulut Ö , Hocaoğlu M , Bulut N , Demi̇rer S , Turgut A , Ovalı F . Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia. Çocuk Dergisi. 2020; 20(3): 100-106.
Vancouver Bulut Ö , Hocaoğlu M , Bulut N , Demi̇rer S , Turgut A , Ovalı F . Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia. Çocuk Dergisi. 2020; 20(3): 100-106.
IEEE Ö. Bulut , M. Hocaoğlu , N. Bulut , S. Demi̇rer , A. Turgut ve F. Ovalı , "Comparison of Risk Factors and Neonatal Outcomes in Early-Onset and Late-Onset Preeclampsia", Çocuk Dergisi, c. 20, sayı. 3, ss. 100-106, Ara. 2021