[Effects of gestational age on perinatal outcomes in patients complicated with early onset severe preeclampsia].

OBJECTIVE

To analysis the relationship between gestational age and perinatal outcomes in patients complicated with early onset severe preeclampsia.

METHODS

Retrospective study was conducted on clinical documents of 221 patients with early onset severe preeclampsia (< 34 weeks) who delivered after 28 gestational weeks in Peking University First Hospital from July 1999 to June 2009. Patients were divided into three groups based on gestational weeks at delivery: group I (n = 81) delivered at 28 - 31 weeks(+6), group II (n = 78) at 32 - 33 weeks(+6) and group III (n = 62) after 34 weeks. The clinical characteristics and perinatal outcomes were compared among those three groups.

RESULTS

(1) Outcome of neonates: Among 221 neonates, 13 neonates lost follow-up, including 9 in group I, 3 in group II, 1 in group III. The incidence of neonatal respiratory distress syndrome (RDS) of 26% (19/72) in group I were significantly higher than 7% (5/75) in group II and 10% (6/61) in group III (P < 0.05). The neonatal mortality rate of (43%, 31/72) in group I were significantly higher than 3% (2/61) in group III and 28% (21/75) in group II (P < 0.05). The incidence of maternal complications showed no statistical difference among three groups. (2) Neonatal death analysis: all neonatal death were due to parents' give up, including 26% (8/31) in group I, 67% (14/21) in group II and 1/2 in group III, which reached statistical difference (P < 0.05).

CONCLUSIONS

The incidence of neonatal RDS in mother with early onset severe preeclampsia was decreased if delivered after 32 weeks, and the perinatal mortality was remarkably decreased if delivered after 34 weeks. Therefore, the perinatal survival rate in women with early onset severe preeclampsia can be improved by minimizing the impact of social factors.