Preeclampsia Prematurity Figshare.xls

Preeclampsia is an unpredictable multiorgan disorder responsible for high maternal and perinatal morbidity and mortality. Delivery is the definite treatment to prevent complications. But the timing of delivery is a challenge. We aim to evaluate the maternal and perinatal outcomes of preeclampsia in accordance with the WHO prematurity criteria in a low-resource country. This cross-sectional study was conducted between January 2017 and December 2019 at Aga Khan University Hospital, Pakistan. All women with preterm preeclampsia were included. Pregnant women with fetal anomalies or incomplete medical records were excluded. The participants were divided into three groups based on the WHO prematurity classification: I. extremely preterm (EPB-24-27+6 weeks), II. very preterm (VPB- 28 and 31+6 weeks), III. moderate to late preterm (MLPB 32-36+6 weeks). Data was analyzed using SPSS 19.0.A total of 324 women were included. Out of these 27%, 10.8%, and 61.7% were delivered as extremely preterm, very preterm, and moderate to late preterm respectively. The mean age, history of miscarriage, parity, and multiple pregnancies were not statistically significant among the groups. 13.9% of women developed serious maternal complications. Intrauterine death occurred in 5.6% of cases, and the rate of IUD was not statistically significant among groups. The median birth weight was significantly lower in the EPB and VPB groups in comparison to the MLPB group. Out of the total, 6.3% of neonates expired, with all deaths in the extremely premature group except one baby who died after 28 weeks gestation. Our study concludes that the neonatal death rate is high when delivery is expedited before 28 weeks of gestation.

子痫前期（Preeclampsia）是一种难以预测的多器官紊乱性疾病，可导致较高的孕产妇及围产儿发病率与死亡率。分娩是预防并发症的确切治疗手段，但分娩时机的选择始终是临床一大挑战。本研究旨在评估资源匮乏国家中，按照世界卫生组织（WHO）早产判定标准分组的子痫前期患者的孕产妇及围产儿结局。本研究为横断面研究，于2017年1月至2019年12月在巴基斯坦阿迦汗大学医院开展。纳入所有早产性子痫前期孕妇，排除合并胎儿畸形或病历资料不完整的妊娠女性。根据WHO早产分类标准，将受试者分为三组：Ⅰ. 极早早产组（extremely preterm birth, EPB：24~27+6周）；Ⅱ. 非常早产组（very preterm birth, VPB：28~31+6周）；Ⅲ. 中晚期早产组（moderate to late preterm birth, MLPB：32~36+6周）。采用SPSS 19.0统计软件进行数据分析。本研究共纳入324名孕妇，其中分别有27%、10.8%及61.7%的孕妇以极早早产、非常早产及中晚期早产方式分娩。三组受试者的平均年龄、流产史、孕产次及多胎妊娠比例均无统计学差异。13.9%的孕妇出现严重孕产妇并发症；5.6%的病例发生宫内死亡（Intrauterine Death, IUD），且各组间宫内死亡发生率无统计学差异。极早早产组与非常早产组的新生儿出生体重中位数显著低于中晚期早产组。本研究队列中共计6.3%的新生儿死亡，除1名妊娠28周后死亡的婴儿外，其余新生儿死亡均发生于极早早产组。本研究结论表明，在妊娠28周前加速分娩时，新生儿死亡率较高。