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Neonatal Outcomes in Preterm Severe Preeclampsia as Compared to Other Etiologies of Prematurity [25K]

INTRODUCTION: To evaluate neonatal outcomes in pregnancies complicated by severe preeclampsia, delivered 24–33 6/7 weeks vs. GA - matched pregnancies with other etiologies of preterm delivery. METHODS: Retrospective case-control study involving patients with expectantly managed severe preeclampsia and patients with other causes of preterm delivery; Queens Hospital Center, 1/2009–10/30/2014. Inclusion criteria (cases): severe preeclampsia, 24 0/7–33 6/7 weeks. Inclusion criteria (controls): non-preeclampsia causes of preterm delivery, 24 0/7–33 6/7 weeks. Exclusion criteria: fetal anomalies, IUFD, HELLP syndrome, eclampsia, multiple gestations. Comparison parameters: baseline demographics, obstetrical history, comorbidities, IUGR, mode of delivery, birth weight, cord pH, Apgar scores, placental histology. Primary outcomes: length of NICU stay. Other outcomes: rates of RDS, neonatal sepsis, IVH, NEC. Continuous variables were analyzed using ANOVA, Mann-Whitney U tests. RESULTS: Cases group 65 patients; controls 165 patients. Mean GA at delivery was similar between groups (29 weeks) Duration of expectant management was similar: 3.8 days cases, 4.8 days controls. Rates of IUGR, SGA, c-section were significantly higher among cases. No significant difference in the rates of IVH, RDS, NEC, neonatal sepsis, death was noted. Length of NICU stay was significantly higher among cases: 34 vs 27 days (P=.024). CONCLUSION: With similar rates of neonatal complication (RDS, IVH, NEC, sepsis, neonatal death), neonates born prior to 33 6/7 weeks, due to severe preeclampsia, require longer NICU stay than neonates delivered preterm due to other etiologies. Severe preterm preeclampsia has no protective effect with respect to neonatal outcomes.