Effects Of Hypertensive Disorders Of Pregnancy On Blood Cells In Twin Preterm Infants

ObjectivesHypertensive disorders of pregnancy(HDP)can affect the blood cells of singleton newborns to varying degrees,but few studies on twin pregnancy have been reported.The purpose of this study was to further understand the effect of hypertensive disorders of pregnancy on blood cells of preterm infants in twin pregnancy by analyzing the changes of blood cells of preterm infants in twin pregnancy with hypertension.MethodsWe used a single-center,retrospective cohort study in this study.Twin preterm infants born in our hospital from October 2019 to October 2022 and transferred to the Neonatal Department within 24 hours after birth were selected as the research subjects.According to whether the mother had hypertensive disorders of pregnancy,they were divided into the HDP group and the non-HDP group,and the HDP group was further divided into the gestational hypertension group and the preeclampsia group according to the severity of the disease.The basic information and blood cell parameters of mother and newborn were collected.SPSS 26.0 statistical software was used to analyze the data.Univariate analysis was used to compare the growth and development of twin preterm infants between the HDP group and the non-HDP group,and regression analysis was used to explore the effect of HDP on blood cells of twin preterm infants.Results1.A total of 261 twin preterm infants were included in this study,including15(59.4%)in the non-HDP group,106(40.6%)in the HDP group.The HDP group included 49 cases(46.2%)of gestational hypertension and 57 cases(53.8%)of preeclampsia.2.There were no significant difference in gender,gestational age,length,head circumference,birth weight,1-minute Apgar score and 5-minute Apgar score,respiratory score and shock score,and umbilical artery blood gas BE value between the HDP group and the non-HDP group(P>0.05).The incidence of SGA was higher in the HDP group(P<0.05).There was no significant difference in the proportion of SGA in twin preterm infants compared with subgroups with different severity of HDP and the non-HDP group(P>0.05).3.There was no leukopenia between the HDP group and the non-HDP group.There was no significant difference in the incidence of neutropenia,polycythemia,and thrombocytopenia between the two groups(P>0.05).Compared with subgroups with different severity of HDP and the non-HDP group,there was no leukopenia in the three groups,and there was no significant difference in the probability of neutropenia,polycythemia,and thrombocytopenia in the three groups(P>0.05).4.Through univariate regression analysis,HDP was an influential factor of white blood cell count(OR=0.91,95%CI: 0.84～0.98,P=0.009),neutrophil count(OR=0.87,95%CI: 0.79～0.95,P=0.002),monocyte count(OR=0.43,95%CI: 0.22～0.82,P=0.011),basophil count(OR=0.01,95%CI: 0.01～0.37,P=0.004),and reticulocyte count(OR=0.01,95%CI: 0.01～0.48,P=0.021),and there was no significant effect on the remaining blood cell parameters(P>0.05).After adjusting the confounding factors by multivariate regression analysis,it was seen that HDP was still an influential factor of the white blood cell count(OR=0.89,95%CI: 0.82～0.96,P=0.005),absolute neutrophil count(OR=0.85,95%CI: 0.77～0.94,P=0.001),and monocyte count(OR=0.40,95%CI: 0.20～0.80,P=0.010).HDP had no significant effect on red blood cell parameters and platelet parameters(P>0.05).5.The HDP group was divided into the gestational hypertension group and the preeclampsia group according to the severity of the disease,and explored the influence of the severity of HDP on the blood cells of twin preterm infants within 24 hours after birth.Multivariate regression analysis showed that the severity of HDP had no significant effect on platelet parameters(P>0.05).The severity of HDP had no significant effect on red blood cell parameters including red blood cell count,hemoglobin,hematocrit,mean corpuscular hemoglobin concentration and nucleated red blood cell count(P>0.05).As the severity of HDP increased,preeclampsia had a negative effect on monocyte count(OR=0.19,95%CI: 0.07～0.55,P=0.002)and reticulocyte count(OR=0.01,95%CI: 0.01～0.54,P=0.031).Conclusions1.Hypertensive disorders of pregnancy do not increase the risk of gestational age loss and birth weight loss in twin preterm infants;the severity of hypertensive disorders of pregnancy has no significant effect on the incidence of small-for-gestational-age.2.Hypertensive disorders of pregnancy can affect some blood cells in twin preterm infants,mainly by reducing white blood cell count and monocyte count,but not increasing the incidence of leukopenia,neutropenia,thrombocytopenia,and polycythemia.