Maternal haemolysis, elevated liver enzymes and low platelets syndrome: perinatal and neurodevelopmental neonatal outcomes for infants weighing less than 1250 g.
OBJECTIVE
To study mortality and short-term morbidity of infants born to women with HELLP (haemolysis, elevated liver enzymes, and low platelets) syndrome and to compare the long-term neurodevelopmental morbidity of a subgroup with birth weight (BWT) less than 1250 g (study group) with weight matched controls.


METHODS
Retrospective chart review and prospective neurodevelopmental follow-up through a Perinatal Follow-up clinic. Analysis of perinatal and neonatal data for women diagnosed with HELLP from 1993 to 1996. Neurodevelopmental outcome for the study group was compared to a group of weight matched controls.


RESULTS
A total of 109 infants (mean gestational age 32.6 weeks, mean BWT 1766 g) were born to 104 women with HELLP syndrome. There was a significant decrease in mortality (P = 0.002) and morbidity (P < 0.05) with increasing gestational age and birthweight. No significant differences in neonatal mortality and morbidity were present between the infants weighing less than 1250 g study and weight matched control group. However, at 3 years, the study group had fewer children with cerebral palsy (P = 0.024) and mental disability (P trend = 0.07). Mean cognitive index was 99 versus 91 in the controls (P = 0.101).


CONCLUSIONS
Improved health outcomes occur with increased gestational age. Infants with BWT less than 1250 g born to women with HELLP syndrome were not at risk of increased neurodevelopmental disability compared to controls.
Singhal
N
N
Division of Neonatology, Department of Paediatrics, University of Calgary, Calgary Health Region, Calgary, Alberta, Canada. nalini.singhal@calgaryhealthregion.ca
Amin
H J
HJ
Pollard
J K
JK
Tough
S C
SC
Johnston
D W
DW
Clark
D J
DJ
Sauve
R
R
D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D017359:HELLP Syndrome / Q000150:complications*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D008297:Male; D009422:Nervous System Diseases / Q000196:embryology / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012189:Retrospective Studies