Infants of mothers with HELLP syndrome compensate intrauterine growth retardation faster than unaffected premature infants: does HELLP change fetal programming?

OBJECT: To investigate the influence of HELLP (hemolysis, elevated liver enzymes and low platelet count) pregnancies on the postpartal course and further development of the neonate.

METHODS

The postnatal course and further development up to 4 years of age of 43 infants after pregnancies complicated by HELLP syndrome were evaluated. 43 unexposed infants matched for gestational age and gender served as controls.

RESULTS

Small-for-gestational age (SGA) neonates exhibiting hypoglycemia and hypoproteinemia during the first 4 weeks after birth were significantly more commonly observed in the HELLP group (p < 0.5). No other differences in the postpartal course or clinical outcome were detected. At the age of 4 years the gains in weight and length were significantly increased in the HELLP group (p < 0.01).

CONCLUSION

The postnatal course of newborns after HELLP pregnancies is influenced by low energy stores. Fetal programming toward a more efficacious GH-IGF-1 pathway may explain the faster postnatal catch-up growth of premature SGA infants born to mothers with HELLP syndrome.