The Relation of Maternal Complications to Outcomes in Very Low Birthweight Infants in an Era of Changing Neonatal Care

Mari Palta; Mona Sadek; Debra Gabbert; William Brady; Marie R. Weinstein; Gail McGuinness; Mary Ellen Peters

doi:10.1055/s-2007-994303

American Journal of Perinatology, Table of Contents

Am J Perinatol 1996; 13(2): 109-114
DOI: 10.1055/s-2007-994303

ORIGINAL ARTICLE

The Relation of Maternal Complications to Outcomes in Very Low Birthweight Infants in an Era of Changing Neonatal Care

Mari Palta, Mona Sadek, Debra Gabbert, William Brady, Marie R. Weinstein, Gail McGuinness, Mary Ellen Peters

Department of Preventive Medicine, Department of Pediatrics, University of Wisconsin, Department of Neonatology, St Mary's Hospital, Madison, Wisconsin, Department of Pediatrics, University of Iowa, Iowa City, Iowa, and Department of Radiology, University of Wisconsin, Madison, Wisconsin

Abstract

ABSTRACT

We examine the relation of key neonatal outcomes to pregnancy complications and to the use of antenatal steroids and investigate whether there is evidence of recent change in this relation. Complete information on pregnancy and neonatal course was available for 749 out of 949 singleton births without major congenital anomalies below 1501 g admitted to seven regional neonatal intensive care units between August 1, 1988 and June 30, 1991. Mortality was highest in infants born after labor with spontaneous rupture of fetal membranes of less than 24 hours duration (odds ratio [OR] =1.6, 95% confidence interval [1.0,2.6]). Spontaneous rupture of membranes of over 24 hours duration was associated with decreased risk of respiratory distress syndrome (OR=0.42, [0.28,0.64]) and decreased risk of patent ductus arteriosus (OR=43, [0.28,0.66]). Pregnancy induced hypertension was associated with increased risk of respiratory distress syndrome in those born at less than 30 weeks' gestation (OR=6.0,[2.0,17]). Labor with or without rupture of membranes of short duration was associated with increased risk of intraventricular hemorrhage (OR= 1.9, [1.2,2.5]). These associations were not different in early versus late time periods of the study. Antenatal steroids were associated with dramatically reduced risk of mortality (OR=0.20, [0.09,0.50]), respiratory distress syndrome (OR=0.52, [0.32,0.85]), and intraventricular hemorrhage (OR=0.37, [0.21-0.65]).

Keywords

Neonatal outcomes - premature delivery - antenatal steroids

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