PREGNANCY INDUCED HYPERTENSION AND NEONATAL GROWTH
Authors: Zisovska Elizabeta , Madzovska Lidija , Dimitrovska Ivanova Marija 
Published: December 2021

Pregnancy-induced hypertension (PIH), especially preeclampsia, is a major cause of maternal and perinatal morbidity and mortality worldwide. The impact of PIH on birth outcomes has not been extensively studied. PIH has been confirmed to increase significantly the risk of low birth weight by both increasing preterm birth as well as reducing fetal growth. Low birth weight or IUGR babies have been associated with the occurrence of several chronic diseases in later life. However, to date, there have been few studies on the effects of PIH on infant growth and neonatal wellbeing. The purpose of this study was to evaluate the fetal growth and wellbeing of newborns born of mothers with confirmed pregnancy induced hypertension.Material and methods: This was prospective opservational study during the period of the last year, 1st of July 2018 up to the end of June 2019 conducted at the University Clinic for Gynecology and Obstetrics in Skopje. As pregnancy induced hypertension is defined the condition of blood pressure equal to or greater than 130/90 mmHg on more than two occasions greater than six hours apart without proteinuria after 21 weeks of gestation. All other more severe conditions are defined as pre-eclampsia or eclampsia. As outcome was considered the birth weight, gestational age and white blood cells count. IUGR was defined as birth weight below the tenth percentile of expected weight for gestational age. Also maternal age and BMI were considered as conjoined risk factor for the birth weight. Results: In this study, 4726 newborns were born at the University Clinic for Gynecology and Obstetrics, and for analysis were considered 4273 newborns who were late preterm (35 and 36 gestational weeks) or term newborns. Two groups were evaluated: control group of 200 consecutively born newborns (late preterm and term) of healthy mothers and 100 newborns (late preterm and term) consecutively born of mothers with confirmed diagnosis of PIH, which constituted the study group. Within the control group, the proportion of Small for Gestational Age-SGA was 6,3%, and in the group of mothers with PIH was 9,5% (p<0,05). The maternal mean age of the hypertensive mothers was (32.8±5.0) years while that of normotensive mothers was (26.6±3.7) years, and there was not statistical significance (p>0.05). The Body Mass Index was higher in hypertensive mothers, compared to the healthy mothers (31,3±2.02 vs. 27.8±2.8). The mean gestational age of the study group was (35.8±1.8) weeks compared to that in control group (37.4±1.2) weeks. The number of White Blood Cells (WBC) count in newborns of hypertensive mothers was 21.4±5.3x109/L compared with the control group, 18.5±3.12x109/L (p=0.005). Neonatal thrombocytopenia was found in 32% of neonates of preeclamptic mothers while it's found only in 9.5% of neonates in control group p<0,002. Discussion: The limitation of this study was the lack of data about maternal smoking, life style, etc. There is limited number of studies examining the correlation between fetal growth and PIH, and every information is of great value. The fact is that this condition can progress in more severe degree of hypertension and deleterious effects on the mother itself and on her child, if not treated on time. Conclusion: A change in infant growth of the IUGR baby itself (e.g. catch-up growth) such as in the critical early infant period may also have long-term effects on health later in life, and this change of postpartum growth may be influenced by PIH. Therefore, it is important to study postpartum infant growth patterns of babies born to mothers with PIH, and to determine if there are differences in infant growth between babies with and those without IUGR. And, the most important action is to monitor and treat pregnancy induced hypertension and prevent more severe condition of pre-eclampsia.