Neonatal outcome in pregnancies after preterm delivery for HELLP syndrome.
OBJECTIVE
To compare neonatal outcome after preterm delivery of infants where pregnancy had been complicated by the HELLP syndrome.


METHODS
The maternal and neonatal charts of 475 consecutive pregnancies complicated by hypertensive disorders at our perinatal unit were reviewed. The HELLP syndrome was defined by previously published laboratory criteria. 93 women fulfilled the criteria and constituted our HELLP syndrome study group. 188 normotensive patients who were delivered because of preterm labor comprised the control group. Results were compared by means of chi2 analysis and Student's t test where appropriate.


RESULTS
There were 518 pregnancies complicated by hypertensive disorders and 93 by HELLP syndrome. The incidence of HELLP syndrome among women with severe preeclampsia was 19.5%. We found a significant difference in the incidence of intrauterine growth restriction (61.2 vs. 5.8%, p < 0.0001), intrauterine fetal death (13.9 vs. 6.9%, p = 0.035), abruptio placenta (13.9 vs. 2.6%, p = 0.001), and fetal distress (35.4 vs. 12.2%, p < 0.0001) between the two groups. There were no significant differences in complications (respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis and sepsis) between the HELLP syndrome group and controls. However, the neonatal death rate and the need for mechanical ventilation and neonatal intensive care were greater in the HELLP syndrome group.


CONCLUSIONS
Our study suggests an increased mortality and morbidity in newborns of mothers complicated with HELLP syndrome that can be partly attributed to increased rates of intrauterine growth restriction and fetal distress, particularly beyond 32 weeks of gestation.
Aslan
Halil
H
SSK Bakirkoy Maternity and Children's Teaching Hospital, Istanbul, Turkey. hail34aslan@hotmail.com
Gul
Ahmet
A
Cebeci
Altan
A
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis* / Q000453:epidemiology; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000453:epidemiology; D005500:Follow-Up Studies; D005865:Gestational Age; D017359:HELLP Syndrome / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D015994:Incidence; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000453:epidemiology; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011256:Pregnancy Outcome; D011336:Probability; D012016:Reference Values; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis* / Q000453:epidemiology; D018570:Risk Assessment