Maternal High Blood Pressure and Newborn's Blood Profile

Study Overview
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Brief Summary
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Maternal high blood pressure remodels the intrauterine environment of the fetus by altering hormonal and cellular signaling patterns and, as a result increases the risk of fetal and neonatal mortality and morbidity. Newborns of these mothers have an increased risk of intrauterine growth restriction, premature birth and hematological abnormalities, such as thrombocytopenia, polycythemia, and neutropenia. The purpose of the article is to review neonatal thrombocytopenia and neutropenia as a consequence of maternal high blood pressure and to establish the optimal management of these cases.

Detailed Description
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Pregnancy induced hypertension (PIH) and preeclampsia (preE) are caused by gestation and have an onset after 20 weeks of pregnancy. Although the exact etiology of PIH and preE remains unknown, two interconnected mechanisms have been identified to play an important role in the pathogenesis: dysfunction of the placental trophoblast and endothelial dysfunction within the maternal systemic vasculature. The endothelium has been identified as the target tissue of the disease. Endothelial alterations ultimately manifest as placental hypoxia and hypoplasia. The neonatal thrombocytopenia and neutropenia after pregnancy-induced hypertension is a result of inhibition of fetal bone marrow production of the myeloid lineage due to intrauterine hypoxic environment. This study aims to investigate the hematological profile in term and preterm infants born to mothers with preeclampsia. The current retrospective observational study was conducted at the Clinic of Obstetrics, Gynecology and Neonatology of the Emergency County Hospital, Timisoara over a period of three years, from January 2014 to December 2016. All inborn patient files were analyzed as anonymised limited data sets from archived records of the Neonatology Department.

Official Title
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Maternal Pregnancy Induced Hypertension and Hematological Profile of Newborns

Conditions
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Maternal-Fetal Exchange

Intervention / Treatment
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* Other: AGA - Control group
* Other: SGA - Control group
* Other: AGA-PIH Study group
* Other: SGA-PIH Study group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age: 0-28 days Newborns of healthy mothers; Newborns of mothers with Pregnancy Induced Hypertension; Inborn Patients; Written Informed Consent signed by legal guardian. Exclusion Criteria: Maternal disease other than PIH; Syndromal, chromosomal or infectious diseases of the newborns; Causes other then PIH for perinatal asphyxia.

Ages Eligible for Study
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Minimum Age: 1 Day
Maximum Age: 28 Days

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| AGA Neonates<br>AGA Control Group Appropriate for gestational age newborns of healthy mothers | Other: AGA - Control group<br>* Data processing from Patient Medical Files<br>|
| SGA Neonates<br>SGA - Control Group Small for gestational age newborns of healthy mothers | Other: SGA - Control group<br>* Data processing from Patient Medical Files<br>|
| AGA-PIH Neonates<br>AGA-PIH Study Group Appropriate for gestational age newborns of mothers with pregnancy induced hypertension | Other: AGA-PIH Study group<br>* Monitoring PIH-related changes in the newborn<br>|
| SGA-PIH Neonates<br>SGA-PIH Study Group Small for gestational age newborns of mothers with pregnancy induced hypertension | Other: SGA-PIH Study group<br>* Monitoring PIH-related changes in the newborn<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hematological Changes in the Newborns of Mothers with Pregnancy Induced Hypertension | Evaluating the impact of Maternal Pregnancy Induced Hypertension on fetal and neonatal hematopoiesis with focus on the myeloid lineage. | Blood profiles of newborns aged between 1-28 days were evaluated. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Maternal PIH, Neonatal thrombocytopenia, Neonatal neutropenia