Effects Of Hypertensive Disorders Of Pregnancy On Respiratory Complications Of Premature Infants Less Than 34 Weeks Gestational Age

Objective:By analyzing the clinical data of preterm infants with gestational age less than 34 weeks born to mothers with hypertensive disorders of pregnancy(HDP),to explore the effect of HDP on the respiratory system and complications of preterm infants,so as to provide theoretical basis for perinatal management of HDP pregnant women and preterm infants.Methods:The clinical data of 183 premature infants with gestational age <34w HDP mothers admitted to NICU in Linyi Central Hospital from January 2019 to January 2021 were analyzed retrospectively.According to the degree of HDP in pregnant mothers,183 premature infants of HDP mothers were divided into gestational hypertension group(n=66),mild preeclampsia group(n=63)and severe preeclampsia group(n=54);101preterm infants hospitalized in the same period of healthy mothers with gestational age<34w were selected as the control group.The general data,respiratory complications,clinical diagnosis,treatment and prognosis of pregnant women and premature infants in each group were collected.Statistical analysis was performed on the above data.Results:1.Comparison of general conditions: in the gestational hypertension group,mild preeclampsia group,severe preeclampsia group and control group,the gestational age,gender,1min Apgar score,5min Apgar score of preterm infants in each group,and the maternal There was no significant difference in age,parity,mode of delivery and use of prenatal hormones among the four groups(P>0.05).Compared with the control group,the ratio of small for gestational age,SGA)and birth weight and cesarean section were significantly different(P<0.05).2.Comparison of respiratory complications in premature infants: The incidence of pneumothorax,apnea,pulmonary hemorrhage,bronchopulmonary dysplasia(BPD)and pneumonia in pregnancy induced hypertension group,mild preeclampsia group and severe preeclampsia group were significantly higher than those in the control group(P<0.05);and the incidence of neonatal respiratory distress syndrome(NRDS)was significantly lower than that in the control group(P < 0.05).The incidences of pneumothorax,apnea,pulmonary hemorrhage,BPD and pneumonia in pregnancy induced hypertension group,mild preeclampsia group and severe preeclampsia group increased in turn with the severity of HDP(P<0.05);the incidence of NRDS decreased gradually with the severity of HDP,and there were significant differences among the three groups(P < 0.05).3.Comparison of respiratory therapy for premature infants: Compared with the control group,the gestational hypertension group,the mild preeclampsia group,and the severe preeclampsia group had significantly higher rates of invasive mechanical ventilation,time,and oxygen use time in preterm infants(P < 0.05),the use rate and repeated use rate of pulmonary surfactant(PS)were lower,and the difference was statistically significant(P<0.05).Comparison among the three groups of HDP,the more severe the HDP,the lower the PS usage rate and the repeated usage rate,and the difference was statistically significant(P<0.05).There was statistical significance(P<0.05),and there was no significant difference in the proportion of non-invasive ventilation and the time of non-invasive ventilation(P>0.05).Conclusions:1.Maternal HDP can increase the incidence of asphyxia,BPD,pneumonia,pulmonary hemorrhage,pneumothorax,and apnea in premature infants,and can increase the time of oxygen use,the proportion of invasive mechanical ventilation,and the duration of ventilation,and it is positively correlated with the severity of maternal HDP.2.The incidence of NRDS,PS usage and the repeated PS usage were lower in preterm infants with HDP mothers,and were negatively correlated with the severity of maternal HDP.