title: Maternal characteristics of a cohort of preterm infants with a birth weight ≤750 g without major structural anomalies and chromosomal abnormalities.
abstract: Our objectives were to describe the obstetric complications of women who delivered an extremely low-birth-weight infant by comparing two consecutive 5-year periods and infants appropriate for gestational age (AGA) versus infants small for gestational age (SGA). This descriptive study included women ( N = 261) who delivered an infant ≤750 g (major structural and chromosomal anomalies excluded) between 1996 and 2000 (cohort I, N = 145) and 2001 to 2005 (cohort II, N = 116) in the University Hospital Utrecht, the Netherlands. Of these, 84.3% of the multigravidas ( N = 121) had a complicated obstetric history: 46.3% miscarriage(s), 22.3% preterm deliveries, and 16.5% hypertensive disorders. In the index pregnancies ( N = 261), the most prevalent complications were hypertensive disorders (52.1%, P = 0.002; more in cohort II) and SGA ( P = 0.007), fetal distress (39.5%), and intrauterine growth restriction (32.6%) resulting in a caesarean section in 47.9% and a spontaneous vaginal delivery in 19.2%. Intrauterine deaths occurred in 35.2%, merely due to placental insufficiency (59.8%) and termination of pregnancy because of deteriorating hypertensive disorders (23.9%). A high percentage of parous mothers had a seriously complicated obstetric history. The index pregnancy was largely complicated by hypertensive disorders. The majority of infants with a birth weight ≤750 g were growth-restricted due to placental insufficiency. Follow-up is extremely important to evaluate neonatal morbidity and neurodevelopmental outcome.
authors.affiliation: Department of Obstetrics and Gynaecology, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, The Netherlands. m.j.claas@umcutrecht.nl
authors.forename: Marieke J
authors.initials: MJ
authors.lastname: Claas
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.forename: Hein W
authors.initials: HW
authors.lastname: Bruinse
mesh_terms: D001724:Birth Weight; D002585:Cesarean Section; D016640:Diabetes, Gestational; D004461:Eclampsia; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005316:Fetal Distress / Q000209:etiology; D005317:Fetal Growth Retardation / Q000209:etiology*; D017359:HELLP Syndrome; D006801:Humans; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D010298:Parity; D010923:Placenta Previa; D010927:Placental Insufficiency; D011225:Pre-Eclampsia; D011247:Pregnancy; D047928:Premature Birth; D017584:Reproductive History; D012189:Retrospective Studies