title: Pregnancies complicated by both preeclampsia and growth restriction between 34 and 37 weeks' gestation are associated with adverse perinatal outcomes.
abstract: OBJECTIVE
  To determine whether adverse outcomes were more common in late preterm pregnancies complicated by preeclampsia and growth restriction compared to those affected by preeclampsia alone.
  
  
  METHODS
  This was a retrospective cohort study of 8927 singleton pregnancies with preeclampsia. Pregnancies with small for gestational age (SGA) neonates (birth weight <10th percentile) were compared to those appropriate for gestational age (AGA) neonates. Maternal outcomes included cesarean delivery (CD) rate, CD for fetal heart rate (FHR) abnormalities, abruption, postpartum hemorrhage (PPH), maternal transfusion, acute renal failure, and peripartum cardiomyopathy. Neonatal outcomes studied included respiratory distress syndrome (RDS), jaundice, hypoglycemia, seizure, asphyxia, neonatal death, and intrauterine fetal demise (IUFD).
  
  
  RESULTS
  Women with preeclampsia and SGA infants were more likely to experience abruption (5.3% versus 3.0%, p < 0.001), higher CD rate (66.5% versus 55.0%, p < 0.001), and higher likelihood of a CD for FHR abnormalities (21.7% versus 10.0%, p < 0.001). SGA infants were more likely to experience adverse neonatal outcomes including RDS (10.1% versus 4.9%, p < 0.001), jaundice (59.8% versus 39.2%, p < 0.001), hypoglycemia (8.9% versus 3.9%, p < 0.001), asphyxia (0.6% versus 0.2%, p = 0.015), and IUFD (1.5% versus 0.3%, p < 0.001).
  
  
  CONCLUSIONS
  Preeclamptic women and their neonates were more likely to experience adverse perinatal outcomes when SGA pregnancies were compared to those with AGA neonates.
authors.affiliation: a Department of Obstetrics and Gynecology , Division of Maternal-Fetal Medicine, Cedars-Sinai Medical Center , Los Angeles , CA , USA and.
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Sharma
authors.affiliation: a Department of Obstetrics and Gynecology , Division of Maternal-Fetal Medicine, Cedars-Sinai Medical Center , Los Angeles , CA , USA and.
authors.forename: Tania F
authors.initials: TF
authors.lastname: Esakoff
authors.affiliation: b Department of Obstetrics and Gynecology , Division of Maternal-Fetal Medicine, Oregon Health & Science University in Portland , Portland , OR , USA.
authors.forename: Alyson
authors.initials: A
authors.lastname: Guillet
authors.affiliation: b Department of Obstetrics and Gynecology , Division of Maternal-Fetal Medicine, Oregon Health & Science University in Portland , Portland , OR , USA.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Burwick
authors.affiliation: b Department of Obstetrics and Gynecology , Division of Maternal-Fetal Medicine, Oregon Health & Science University in Portland , Portland , OR , USA.
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Preeclampsia; expectant management; growth restriction; late preterm