The "weight" of fetal growth restriction in 437 hypertensive pregnancies.
OBJECTIVE
Our objective was to evaluate the outcomes of the hypertensive and preeclamptic pregnancies with or without fetal growth restriction (FGR).


METHODS
We retrospectively studied 437 hypertensive pregnant women treated by calcium antagonists and divided in four groups: Gestational hypertension (GH) with or without FGR (GH-AGA: 244; GH-FGR: 78) and preeclampsia (PE) with or without FGR (PE-AGA: 76; PE-FGR: 39). Outcomes considered were: the need for a second-line treatment, prolongation of the pregnancy after diagnosis, duration of treatment in puerperium, gestational age at delivery, neonatal birth weight, perinatal mortality and neonatal malformations.


RESULTS
A second line treatment was added in: GH-AGA: 15.4% vs. GH-FGR: 32.8%; PE-AGA: 28% vs. PE-FGR: 50%. We found a significant difference in delivery delay after diagnosis (31.3+/-5.4 vs. 20.7+/-3.4 days and 35.3+/-4.5 vs. 22.2+/-3.1; p<0.001). Gestational age at delivery was (p<0.001): 35.5+/-2.3 vs. 35.6+/-2.5 and 34.4+/-1.7 vs. 33.1+/-2.3. A significant difference in birth weight was (p<0.001): 2,271+/-759.1 vs. 1,817.59+/-396.9 and 2,196+/-685.17 vs. 1,465.80+/-441.7. Mortality was 2.56% (2 cases) for GH-FGR and 10.2% (4 cases) for PE-FGR. No neonates showed malformations.


CONCLUSIONS
Gestational hypertension and preeclampsia increase the risk of low birth weight, on the other hand the fetal growth restriction is a determinant factor for the outcome of hypertensive and preeclamptic pregnancy, perinatal morbidity and mortality of the fetus and for the management and treatment efficacy of the mother.
Tranquilli
Andrea Luigi
AL
Department of Obstetrics and Gynecology, University of Ancona Salesi Hospital, via Corridoni 11, 60123 Ancona, Italy.
Giannubilo
Stefano Raffaele
SR
D001724:Birth Weight; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D036861:Delivery, Obstetric; D005260:Female; D005317:Fetal Growth Retardation / Q000150:complications* / Q000503:physiopathology*; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy / Q000503:physiopathology*; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
D002121:Calcium Channel Blockers