A Reunion Survey Of104Cases Of Severe Preeclampsia Patients And Their Children

Background and ObjectivesHypertensive disorders complicating pregnancy is a syndrome which affects5to8%of pregnant women,and the death rate is10%~16%of the total number ofpregnancy-related deaths. It contributes greatly to maternal morbidity and mortalityrates. The working group classification of hypertensive disorders complicatingpregnancy includes four types of hypertensive disease: gestational hypertension,preeclampsia and eclampsia syndrome,preeclampsia syndrome superimposed onchronic hypertension and chronic hypertension.Preeclampsia(PE) is a disease whichoccurs gestational hypertension with proteinuria after20weeks pregnant.It’s verycommom in hypertensive disorders complicating pregnancy and can be associatedwith heart, brain, kidney, liver and other viscera function damage.What’s more,PE isthe leading cause of maternal and infant morbidity and mortality rates.Refer to relevant information, more and more people set out to study the etiologyand pathogenesis of severe preeclampsia(sPE), but the long-term prognosis of sPEpatients and their children’s growth and development situation are rarely reported inChina. Although there are many studies abroad, the results may not suitable in ourcountry for the racial and regional differences.So we still need further researchesabout sPE in our country.The objectives of this study are as follows:1.Compare the newborns’ outcome of early onset severe preeclampsia(EOSP, onset gestafional week≤34),late onset severe preeclampsia(LOSP, onset gestationalweeks>34) and normal pregnant to explore the differences of the three groups.2.Compare the growth and development situation of normal pre-schoolchildren,EOSP patients’ children and LOSP patients’ children,all of the children areunder5year-old,to explore the differences of the three groups.3. To learn body recovery of EOSP and LOSP patients12weeks postpartum,and the long-term prognosis of the patients,then make a comparison of the twogroups.Through the three aspects’ data collection and comparison to guide clinicians tocarry on positive and effective treatments for EOSP and LOSP patients,and to remindthe related departments to pay more attention on severe preeclampsia patients andtheir children’s long-term health, in order to complete primary prevention for relateddiseases.Materials and MethodsClinical data of104single pregnancy cases of severe preeclampsia in the secondaffiliated hospital of Zhengzhou university from March2008to February2012，werecollected and then analyzed．The patients were divided into two groups，47cases ofearly onset severe preeclampsia group(onset gestafional week≤34)and57cases of lateonset severe preeclampsia group(onset gestational weeks>34)．Otherwise,clinical dataof31single pregnancy cases of normal pregnant women during this period werecollected. Growth reference standards of children under the age of7in China,whichmade by the Department of maternal and child health care and Community HealthDivision of China,Sept.2009,also bring into this research. According to the contactinformation of severe preeclampsia patients, long-term data out-of-hospital werecollected. In the severe preeclampsia patients,34cases of early onset severepreeclampsia were collected(returning rate72.34%) and46cases of late onset severepreeclampsia were collected(returning rate80.70%).This research includes three parts:the first part compared the newborns’ heightand weight of EOSP, LOSP and normal pregnant to explore the difference of the threegroups.By telephone interview,the second part compared the growth and developmentsituation of normal pre-school children,EOSP patients’ children and LOSP patients’ children from1to5year-old.The third part collected and analyzed data on bloodpressure(BP) of EOSP and LOSP patients12weeks postpartum, and the long-termcondition of the patients.Results1.The newborns’ outcome of EOSP, LOSP and normal pregnantIn the three groups,EOSP infants death rate reached23.4%,and no death infantwas seen in the other two groups.The height and weight of normal pregnant infantswere higher than EOSP and LOSP infants,the differences were statisticallysignificant(P＜0.05); the height and weight of EOSP infants were higher than LOSPinfants, the differences were statistically significant(P＜0.05).2. The growth and development situation of EOSP children and LOSP childrenfrom1to5year-oldNo matter EOSP or LOSP,80.00%of the low birth weight infants’ physicalgrowth and development situation get up to the national standard during1month to1year after their birth.Except the5year-old LOSP children’s height has difference withnormal children’s (P＜0.05), compared the three groups,there was no height andweight differences in the1to5year-old children between the three group（sP＞0.05）.3. Body recovery of EOSP and LOSP patients12weeks postpartum, and thelong-term condition of the patientsThere are12women’s blood pressure didn’t return to normal in EOSP(35.29%),and7in LOSP(15.22%)12weeks postpartum. Compared the twogroups,EOSP’s BP is worse than LOSP’s, the difference was statistically significant(P＜0.05).Conclusions1. More deaths occurs in EOSP infants.The infants outcome of LOSP is muchbetter than the EOSP,but worse than normal infants.2.No matter EOSP or LOSP,most of the low birth weight infants’ physicalgrowth and development situation catch to the national standard during1month to1year after their birth.3.SPE children show more deficiency in gross motor and imblanance,and thesituation is worse in EOSP children. 4.There was no obvious difference among EOSP,LOSP and normal childrenfrom1to5year-old with their growth and intelligence development.5.EOSP patients are more likely to suffer chronic hypertension than LOSPpatients after delivery.