Association between preeclamptic women and neonatal respiratory distress
Keywords:
Preeclampsia, Respiratory distress, Newborn, AdmissionAbstract
Background: Neonatal respiratory distress (RD) is a common cause of admission to neonatal intensive care units. The condition arises from both pulmonary and extrapulmonary abnormalities. Several factors contributing to respiratory distress in newborns, including preeclamptic mothers. Pattani Hospital has a relatively high incidence of preeclampsia and RD. However, the casual relationship between RD and preeclampsia remains inconclusive.
Objective: To investigate the causal relationship between preeclampsia and RD.
Method: This study is a confirmative etiognostic research (risk factor) using a retrospective observational sub-cohort sampling design at the Obstetrics and Gynecology and Pediatric Departments of Pattani Hospital. The study included newborns with and without RD born to mothers with preeclampsia and mothers with normal blood pressure, between January to June 2023. Data were collected from newborns delivered by mothers with preeclampsia (index cohort) during the study period and randomly sample newborns delivered by mothers with normal blood pressure (referent sub-cohort sampling) on the same dates as the index cohort in the same database. Data were retrieved from patient medical records and the hospital’s Hos-Xp program. Compared the risk factors for RD between the two cohorts using exact probability tests and t-tests. Analyzed the causal pathways of the relationship using structural equation modeling (SEM).
Result: Among patients from both cohorts, there were 46 newborns with RD and 228 newborns without RD. Factors potentially associated with RD in newborns, identified through SEM include: 1. Low birth weight, LBW (<2,500 gm; OR=4.03; 95% CI; 1.78, 9.09), 2. Preterm (OR=2.49; 95% CI; 1.11, 5.56), and 3. Gestational diabetes mellitus (GDM) (OR=3.00; 95% CI; 1.55, 5.79). The preeclamptic women increased the risk by only 1.30 times and it was not statistically significant. Significant pathways were identified between preeclampsia and preterm birth, preterm birth and LBW, and LBW and RD across three pathways, however, GDM was not part of these pathways.
Conclusion: Preeclampsia did not have a direct effect on the occurrence of neonatal respiratory distress, however, it had an indirect effect through preterm birth, and low birth weight.
Downloads
References
Edwards MO, Kotecha SJ, Kotecha S. Respiratory distress of the term newborn infant. Paediatr Respir Rev. 2013 ;14:29–37.
Keerti S, Manish S. Neonatal respiratory distress in early neonatal period and its outcome. Int J of Biomed & Adv Res. 2015;6:643-7.
พรมวงศ์ น. อุบัติการณ์และปัจจัยที่สัมพันธ์กับภาวะหายใจลำบาก ของทารกแรกเกิดในโรงพยาบาลระดับทุติยภูมิ. วารสารกุมารเวชศาสตร์. 2023;62:93-105.
Hermansen CL, Mahajan A. Newborn respiratory distress. Am Fam Physician. 2015;92:994–1002.
Lokanuwatsatien T, Kositamongkol S, Prachukthum S. Incidence, presentation, risk factors and causes of respiratory distress in term newborns at Thammasat University Hospital. Thammasat Med J. 2020;20:130-6.
Osungbade KO, Ige OK. Public health perspectives of preeclampsia in developing countries: Implication for health system strengthening. J Pregnancy. 2011;2011:e481095.
Macedo TCC, Montagna E, Trevisan CM, Zaia V, de Oliveira R, Barbosa CP, et al. Prevalence of preeclampsia and eclampsia in adolescent pregnancy: A systematic review and meta-analysis of 291,247 adolescents worldwide since 1969. Eur J Obstet Gynecol Reprod Biol. 2020;248:177–86.
McKenzie KA, Trotman H. A retrospective study of neonatal outcome in preeclampsia at the university hospital of the West Indies: A resource-limited setting. J Trop Pediatr. 2019;65:78–83.
Wen YH, Yang HI, Chou HC, Chen CY, Hsieh WS, Tsou KI, et al. Association of maternal preeclampsia with neonatal respiratory distress syndrome in very-low-birth-weight infants. Sci Rep. 2019;9:13212.
Chang J, Menard MK, Vermillion ST, Hulsey T . The association between hyaline membrane disease and preeclampsia. Am J Obstet Gynecol. 2004;191:1417-22.
Tian T, Wang L, Ye R, Liu J, Ren A. Maternal hypertension, preeclampsia, and risk of neonatal respiratory disorders in a large-prospective cohort study. Pregnancy Hypertens. 2020;19:131–7.
Langenveld J, Ravelli ACJ, van Kaam AH, van der Ham DP, van Pampus MG, Porath M, et al. Neonatal outcome of pregnancies complicated by hypertensive disorders between 34 and 37 weeks of gestation: A 7 year retrospective analysis of a national registry. Am J Obstet Gynecol. 2011 ;205:540.e1-540.e7.
ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2019 ;133:1.
Ersch J, Roth-Kleiner M, Baeckert P, Bucher HU. Increasing incidence of respiratory distress in neonates. Acta Paediatr . 2007;96:1577–81.
Omani-Samani R, Ranjbaran M, Amini P, Esmailzadeh A, Sepidarkish M, Almasi-Hashiani A. adverse maternal and neonatal outcomes in women with preeclampsia in Iran. J Matern Fetal Neonatal Med. 2019;32:212–16.
Khader YS, Batieha A, Al-njadat RA, Hijazi SS. Preeclampsia in Jordan: incidence, risk factors, and its associated maternal and neonatal outcomes. J Matern Fetal Neonatal Med. 2018;31:770–6.
Davies EL, Bell JS, Bhattacharya S. Preeclampsia and preterm delivery: A population-based case-control study. Hypertens Pregnancy. 2016;35:510–19.
Aynalem YA, Mekonen H, Akalu TY, Habtewold TD, Endalamaw A, Petrucka PM, et al. Incidence of respiratory distress and its predictors among neonates admitted to the neonatal intensive care unit, Black Lion Specialized Hospital, Addis Ababa, Ethiopia. PLoS ONE. 2020;15:e0235544.
Dani C, Reali MF, Bertini G, Wiechmann L, Spagnolo A, Tangucci M, et al. Risk factors for the development of respiratory distress syndrome and transient tachypnoea in newborn infants. Italian Group of Neonatal Pneumology. Eur Respir J. 1999;14:155–9.
Kawakita T, Bowers K, Hazrati S, Zhang C, Grewal J, Chen Z, et al. Increased neonatal respiratory morbidity associated with gestational and pregestational diabetes: Aretrospective study. Am J Perinatol. 2017;34:1160–8.
Becquet O, El Khabbaz F, Alberti C, Mohamed D, Blachier A, Biran V, et al. Insulin treatment of maternal diabetes mellitus and respiratory outcome in late-preterm and term singletons. BMJ Open. 2015;5:e008192.
Fung GPG, Chan LM, Ho YC, To WK, Chan HB, Lao TT. Does gestational diabetes mellitus affect respiratory outcome in late-preterm infants? Early Hum Dev. 2014;90:527–30.
Li Y, Wang W, Zhang D. Maternal diabetes mellitus and risk of neonatal respiratory distress syndrome: A meta-analysis. Acta Diabetol. 2019;56:729–40.
Bricelj K, Tul N, Lucovnik M, Kronhauser-Cerar L, Steblovnik L, Verdenik I, et al. Neonatal respiratory morbidity in late-preterm births in pregnancies with and without gestational diabetes mellitus. J Matern-Fetal Neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet. 2017;30:377–9.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 The Royal College of Pediatricians Of Thailand
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
