Are maternal hypertension and small-for-gestational age risk factors for severe intraventricular hemorrhage and cystic periventricular leukomalacia? Results of the EPIPAGE cohort study.
OBJECTIVE
The purpose of this study was to examine the relationships between different causes of preterm delivery (eg, maternal hypertension, small-for-gestational age [SGA], other) and cerebral damage (eg, cystic periventricular leukomalacia [c-PVL], grade III intraventricular hemorrhage [IVH], and intra-parenchymal hemorrhage [IPH]).


METHODS
This study included 1902 very preterm singletons who were transferred to neonatal intensive care units in 9 French regions. We used logistic regression models to compare the risk of cerebral injury associated with maternal hypertension, SGA, and all other causes of preterm delivery.


RESULTS
We found that the risk of c-PVL and grade III IVH was higher in infants born after preterm premature rupture of membranes (PPROM) with short latency or idiopathic preterm labor than in infants born to hypertensive mothers. We show that SGA and antepartum maternal hemorrhage significantly increase the risk of IPH.


CONCLUSIONS
Our results show that infants born to hypertensive mothers have a lower risk of cerebral injuries than infants born following idiopathic preterm labor and PPROM because they are less exposed to prenatal infection.
Ancel
Pierre-Yves
PY
Inserm U149 Research Unit on Perinatal Health and Women's Health, Villejuif, France. ancel@vjf.inserm.fr
Marret
Stéphane
S
Larroque
Béatrice
B
Arnaud
Catherine
C
Zupan-Simunek
Véronique
V
Voyer
Marcel
M
Rozé
Jean-Christophe
JC
Matis
Jacqueline
J
Burguet
Antoine
A
Ledésert
Bernard
B
André
Monique
M
Pierrat
Véronique
V
Kaminski
Monique
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D002552:Cerebral Ventricles; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007969:Leukomalacia, Periventricular / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D008297:Male; D007752:Obstetric Labor, Premature / Q000150:complications; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D014592:Uterine Hemorrhage / Q000150:complications
D000305:Adrenal Cortex Hormones