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Am J Perinatol
DOI: 10.1055/s-0044-1779254
Original Article

Effect of Maternal Preeclampsia on Cardiac Structure and Function in Very Low Birth Weight Infants

GoleNaz A. Kohbodi
1   Division of Neonatology, Los Angeles General Medical Center, Keck School of Medicine of University of Southern California, Los Angeles, California
,
Rowena G. Cayabyab
1   Division of Neonatology, Los Angeles General Medical Center, Keck School of Medicine of University of Southern California, Los Angeles, California
,
Rutuja N. Kibe
1   Division of Neonatology, Los Angeles General Medical Center, Keck School of Medicine of University of Southern California, Los Angeles, California
,
Mahmoud Ebrahimi
1   Division of Neonatology, Los Angeles General Medical Center, Keck School of Medicine of University of Southern California, Los Angeles, California
,
Lorayne Barton
1   Division of Neonatology, Los Angeles General Medical Center, Keck School of Medicine of University of Southern California, Los Angeles, California
,
Merujan Y. Uzunyan
2   Division of Cardiology, Department of Pediatrics, Los Angeles General Medical Center, Keck School of Medicine of University of Southern California, Los Angeles, California
,
Rangasamy Ramanathan 
1   Division of Neonatology, Los Angeles General Medical Center, Keck School of Medicine of University of Southern California, Los Angeles, California
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Abstract

Objective We aimed to determine whether exposure to severe maternal preeclampsia (PE) in very low birth weight (VLBW) infants is associated with hypertrophic cardiac changes and altered hemodynamics.

Study Design Case–control study of VLBW infants born at Los Angeles General Medical Center from May 2015 to August 2023, who had an echocardiogram within the first 7 days of life. Cases were infants exposed to maternal PE and controls were infants not exposed to maternal PE matched by birth weight (BW) 1:1. Laboratory, placental pathology results, hemodynamic data and clinical outcomes were collected and compared between cases and control infants.

Results A total of 43 cases matched by BW with control infants were studied. There were no significant anatomical cardiac changes by echocardiography between cases and control infants. Cases had significantly higher blood pressure within the first 72 hours of life and lower ejection fraction (EF), fractional shortening, and peak systolic flow velocity through their patent ductus arteriosus (PDA) within the first week of life. Cases were more likely to be smaller despite being born at a later gestational age (GA), as well as small for GA with placental weight less than 10th percentile compared to control infants.

Conclusion Our findings indicate that infants born to mothers with PE have higher systemic vascular resistance as evidenced by elevated blood pressure, and lower EF and shortening fraction and higher pulmonary vascular resistance as evidenced by lower peak flow velocity through the PDA. We did not observe hypertrophic cardiac changes in exposed infants. These findings should be considered in clinical decision-making during management of these infants.

Key Points

  • VLBW infants exposed to severe PE have higher rate of Small for gestational age and smaller placentas.

  • VLBW infants exposed to severe PE have higher systemic vascular resistance during transitional period and lower EF and fractional shortening.

  • VLBW infants exposed to severe PE have higher pulmonary vascular resistance.

Keywords

preeclampsia - preterm infants - cardiac function - blood pressure - hypotension - echocardiogram


Publication History

Received: 28 October 2022

Accepted: 01 January 2024

Article published online:
24 January 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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