Maternal toxemia is associated with reduced incidence of germinal matrix hemorrhage in premature babies.
To evaluate prenatal and perinatal risk factors for development of germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH), we conducted a prospective epidemiologic study of 449 babies whose birth weight was less than 1501 grams. This study permitted us to test our previously generated hypothesis that babies born to mothers with preeclampsia were at substantially reduced risk of developing GMH-IVH. Seventy-two (16%) of the babies in this population developed GMH-IVH. One (2.5%) of the 40 mothers with a diagnosis of preeclampsia and 71 (17.4%) of 409 mothers without preeclampsia gave birth to babies who developed GMH-IVH. GMH-IVH was seen in 6/107 (5.6%) of babies born to women with hypertension including 4/69 (5.8%) of babies born to women with pregnancy-induced hypertension, compared to 66/352 (18.8%) of babies born to mothers who did not have hypertension. Only 7.3% (8/108) of babies born to women who had proteinuria had GMH-IVH, compared to 18.3% (64/350) of babies whose mothers did not have proteinuria. GMH-IVH was seen in 5/89 (5.6%) of babies whose mothers had both hypertension and proteinuria, whereas 63/332 (19%) of babies born to mothers who lacked both factors, developed GMH-IVH. In stepwise logistic regression analysis, these significant findings were not explained by the presence of labor, postnatal acidemia, need for intubation, antenatal administration of steroids, birth weight, or gestational age. In addition, we found that maternal receipt of magnesium sulfate was associated with diminished risk of GMH-IVH even in those babies born to mothers who apparently did not have preeclampsia.(ABSTRACT TRUNCATED AT 250 WORDS)
Kuban
K C
KC
Department of Neurology, Children's Hospital, Boston, MA 02115.
Leviton
A
A
Pagano
M
M
Fenton
T
T
Strassfeld
R
R
Wolff
M
M
D002543:Cerebral Hemorrhage / Q000209:etiology*; D002547:Cerebral Palsy / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology*; D008278:Magnesium Sulfate / Q000627:therapeutic use; D010634:Phenobarbital / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000150:complications* / Q000188:drug therapy; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies
D008278:Magnesium Sulfate; D010634:Phenobarbital