Outcomes of Infants of Mothers with Preeclampsia

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neonatology".

Deadline for manuscript submissions: closed (30 April 2021) | Viewed by 7224

Special Issue Editor


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Guest Editor
Department of Obstetrics and Gynecology, Pomeranian Medical University in Szczecin, Szczecin, Poland
Interests: preeclampsia; FGR; placental insufficiency; placental invasion; angiogenesis markers; ultrasound; perinatal outcomes; placental aging; placental malperfusion
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Special Issue Information

Dear Colleagues,

Preeclampsia (PE) and other placental hypoperfusion-related conditions account for almost 6–10% of gestational complications and have become more and more prevalent in recent decades.

Throughout the years, the name of this condition has changed quite radically a number of times. Initially, it was referred to as toxemia of pregnancy, later as EPH gestosis that consisted of a triad of clinical symptoms, namely, edema proteinuria–hypertension. Attempts to redefine the problem have resulted in identifying two forms of preeclampsia: one with an early onset, developing before the end of the 34th week of pregnancy, and one with a late onset, developing after the 34th week of pregnancy. Some authors consider late preeclampsia to be a separate disease entity with a different pathogenesis. In some cases, fetal growth restriction (FGR) has the same etiology as preeclampsia, but its clinical manifestation pertains to the fetus. FGR often remains the only clinical symptom, while the mother demonstrates none.

Placental insufficiency affects perinatal outcome in newborns and has long-term effects in children. These both result from iatrogenic effects resulting in preterm labor such as changes in metabolism that are termed fetal programming. Chronic changes in the intrauterine environment affect the functions of the circulatory system, the central nervous system, alimentary, and many others, which are currently the subject of numerous studies.

A Special Issue will be devoted to the assessment of both the early and late consequences of delivering births from pregnancies complicated by preeclampsia and its impact on the condition, well-being, and development of newborns and children.

Dr. Sebastian Kwiatkowski
Guest Editor

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Keywords

  • Fetal programming 
  • Intensive care unit—ICU 
  • Organ function 
  • Short–long-term results 
  • Placental insufficiency 
  • Small for gestational age (SGA) 
  • Fetal growth restriction (FGR)

Published Papers (4 papers)

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Editorial

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2 pages, 165 KiB  
Editorial
Editorial to Special Issue
by Sebastian Kwiatkowski
Children 2022, 9(8), 1178; https://0-doi-org.brum.beds.ac.uk/10.3390/children9081178 - 05 Aug 2022
Viewed by 899
Abstract
The definition of preeclampsia has been subject to dramatic changes over the past twenty years [...] Full article
(This article belongs to the Special Issue Outcomes of Infants of Mothers with Preeclampsia)

Research

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7 pages, 226 KiB  
Article
sFlt-1/PlGF Ratio in Prediction of Short-Term Neonatal Outcome of Small for Gestational Age Neonates
by Jacek Witwicki, Katarzyna Chaberek, Natalia Szymecka-Samaha, Adam Krysiak, Paweł Pietruski and Katarzyna Kosińska-Kaczyńska
Children 2021, 8(8), 718; https://0-doi-org.brum.beds.ac.uk/10.3390/children8080718 - 23 Aug 2021
Cited by 4 | Viewed by 1600
Abstract
Background: Small for gestational age is a pregnancy complication associated with a variety of adverse perinatal outcomes. The aim of the study was to investigate if sFlt-1/PlGF ratio is related to adverse short-term neonatal outcome in neonates small for gestational age in normotensive [...] Read more.
Background: Small for gestational age is a pregnancy complication associated with a variety of adverse perinatal outcomes. The aim of the study was to investigate if sFlt-1/PlGF ratio is related to adverse short-term neonatal outcome in neonates small for gestational age in normotensive pregnancy. Methods: A prospective observational study was conducted. Serum sFlt-1/PlGF ratio was measured in women in singleton gestation diagnosed with fetus small for gestational age. Short-term neonatal outcome analyzed in the period between birth and discharge home. Results: Eighty-two women were included. Women with sFlt-1/PlGF ratio ≥33 gave birth to neonates with lower birthweight at lower gestational age. Neonates from high ratio group suffered from respiratory disorders and NEC significantly more often. They were hospitalized at NICU more often and were discharged home significantly later. sFlt-1/PlGF ratio predicted combined neonatal outcome with sensitivity of 73% and specificity of 82.2%. Conclusions: sFlt-1/PlGF ratio is a useful toll in prediction of short-term adverse neonatal outcome in SGA pregnancies. Full article
(This article belongs to the Special Issue Outcomes of Infants of Mothers with Preeclampsia)
12 pages, 258 KiB  
Article
Growth Abnormalities as a Risk Factor of Adverse Neonatal Outcome in Hypertensive Pregnancies—A Single-Center Retrospective Cohort Study
by Anna Kajdy, Stepan Feduniw, Jan Modzelewski, Dorota Sys, Dagmara Filipecka-Tyczka, Katarzyna Muzyka-Placzyńska, Paweł Kiczmer, Bartłomiej Grabowski and Michał Rabijewski
Children 2021, 8(6), 522; https://0-doi-org.brum.beds.ac.uk/10.3390/children8060522 - 19 Jun 2021
Cited by 2 | Viewed by 1999
Abstract
(1) Background: Hypertensive disorders of pregnancy (HDP) include gestational hypertension (GH), chronic hypertension (CH), preeclampsia (PE), and preeclampsia superimposed on chronic hypertension (CH with PE). HDP is associated with several short and long-term perinatal and neonatal complications, such as newborn growth restriction and [...] Read more.
(1) Background: Hypertensive disorders of pregnancy (HDP) include gestational hypertension (GH), chronic hypertension (CH), preeclampsia (PE), and preeclampsia superimposed on chronic hypertension (CH with PE). HDP is associated with several short and long-term perinatal and neonatal complications, such as newborn growth restriction and death. This study aimed to establish the association between HDP, newborn growth abnormalities, and neonatal outcome. (2) Methods: This is a single-center retrospective cohort study of 63651 singleton deliveries. (3) Results: Univariate analysis showed a significantly increased risk of intrauterine and neonatal death associated with maternal hypertension and growth disorders. There were differences between growth charts used, with the highest risk of stillbirth for SGA defined by the Intergrowth chart (OR 17.2) and neonatal death for newborn growth restriction (NGR) based on Intergrowth (OR 19.1). Multivariate analysis showed that NGR is a stronger risk factor of neonatal death than SGA only. (4) Conclusions: HDP is significantly associated with growth abnormalities and is an independent risk factor of adverse outcomes. The presence of newborn growth restriction is strongly associated with the risk of neonatal death. The choice of growth chart has a substantial effect on the percentage of diagnosis of SGA and NGR. Full article
(This article belongs to the Special Issue Outcomes of Infants of Mothers with Preeclampsia)

Review

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17 pages, 2124 KiB  
Review
Neurologic Sequelae Associated with Hypertensive Disorders of Pregnancy
by Mark S. Scher
Children 2021, 8(11), 945; https://0-doi-org.brum.beds.ac.uk/10.3390/children8110945 - 20 Oct 2021
Cited by 4 | Viewed by 1965
Abstract
Hypertensive disorders of pregnancy (HDP) contribute to adverse gene-environment interactions prior to conception and continue throughout pregnancy. Embryonic/fetal brain disorders occur from interactions between genetic susceptibilities interacting with acquired diseases or conditions affecting the maternal/placental fetal (MPF) triad. Trimester-specific pathophysiological mechanisms, such as [...] Read more.
Hypertensive disorders of pregnancy (HDP) contribute to adverse gene-environment interactions prior to conception and continue throughout pregnancy. Embryonic/fetal brain disorders occur from interactions between genetic susceptibilities interacting with acquired diseases or conditions affecting the maternal/placental fetal (MPF) triad. Trimester-specific pathophysiological mechanisms, such as maternal immune activation and ischemic placental syndrome, contribute to adverse peripartum, neonatal and childhood outcomes. Two diagnostic approaches provide timelier diagnoses over the first 1000 days from conception until two years of age. Horizontal analyses assess the maturation of the triad, neonate and child. Vertical analyses consider systems-biology from genetic, molecular, cellular, tissue through organ networks during each developmental niche. Disease expressions associated with HDP have cumulative adverse effects across the lifespan when subjected to subsequent adverse events. Critical/sensitive periods of developmental neuroplasticity over the first 1000 days are more likely to result in permanent sequelae. Novel diagnostic approaches, beginning during pre-conception, will facilitate the development of effective preventive, rescue and reparative neurotherapeutic strategies in response to HDP-related trimester-specific disease pathways. Public health policies require the inclusion of women’s health advocacy during and beyond their reproductive years to reduce sequelae experienced by mothers and their offspring. A lower global burden of neurologic disease from HDP will benefit future generations. Full article
(This article belongs to the Special Issue Outcomes of Infants of Mothers with Preeclampsia)
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