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| Name | Class |
|---|---|
| University of Medicine and Pharmacy "Victor Babes" Timisoara | OTHER |
| TimiÅŸoara County Emergency Clinical Hospital | OTHER |
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Maternal high blood pressure remodels the intrauterine environment of the fetus by altering hormonal and cellular signaling patterns and, as a result increases the risk of fetal and neonatal mortality and morbidity. Newborns of these mothers have an increased risk of intrauterine growth restriction, premature birth and hematological abnormalities, such as thrombocytopenia, polycythemia, and neutropenia. The purpose of the article is to review neonatal thrombocytopenia and neutropenia as a consequence of maternal high blood pressure and to establish the optimal management of these cases.
Pregnancy induced hypertension (PIH) and preeclampsia (preE) are caused by gestation and have an onset after 20 weeks of pregnancy. Although the exact etiology of PIH and preE remains unknown, two interconnected mechanisms have been identified to play an important role in the pathogenesis: dysfunction of the placental trophoblast and endothelial dysfunction within the maternal systemic vasculature. The endothelium has been identified as the target tissue of the disease. Endothelial alterations ultimately manifest as placental hypoxia and hypoplasia. The neonatal thrombocytopenia and neutropenia after pregnancy-induced hypertension is a result of inhibition of fetal bone marrow production of the myeloid lineage due to intrauterine hypoxic environment. This study aims to investigate the hematological profile in term and preterm infants born to mothers with preeclampsia. The current retrospective observational study was conducted at the Clinic of Obstetrics, Gynecology and Neonatology of the Emergency County Hospital, Timisoara over a period of three years, from January 2014 to December 2016. All inborn patient files were analyzed as anonymised limited data sets from archived records of the Neonatology Department.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AGA Neonates | AGA Control Group Appropriate for gestational age newborns of healthy mothers |
| |
| SGA Neonates | SGA - Control Group Small for gestational age newborns of healthy mothers |
| |
| AGA-PIH Neonates | AGA-PIH Study Group Appropriate for gestational age newborns of mothers with pregnancy induced hypertension |
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| SGA-PIH Neonates | SGA-PIH Study Group Small for gestational age newborns of mothers with pregnancy induced hypertension |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AGA - Control group | Other | Data processing from Patient Medical Files |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Hematological Changes in the Newborns of Mothers with Pregnancy Induced Hypertension | Evaluating the impact of Maternal Pregnancy Induced Hypertension on fetal and neonatal hematopoiesis with focus on the myeloid lineage. | Blood profiles of newborns aged between 1-28 days were evaluated. |
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Inclusion Criteria:
Exclusion Criteria:
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All newborns admitted to the Neonatology Department who met the Inclusion Criteria.
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| Name | Affiliation | Role |
|---|---|---|
| Alexandru Florin Rogobete, PhDs | Romanian Society of Anesthesia and Intensive Care | Principal Investigator |
| Dorel Sandesc, Prof | Romanian Society of Anesthesia and Intensive Care | Study Chair |
| Ovidiu Bedreag, Assoc Prof | Romanian Society of Anesthesia and Intensive Care | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Romanian Society of Anesthesia and Intensive Care | Timișoara | Romania |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 18759083 | Background | Bhat YR, Cherian CS. Neonatal thrombocytopenia associated with maternal pregnancy induced hypertension. Indian J Pediatr. 2008 Jun;75(6):571-3. doi: 10.1007/s12098-008-0110-x. Epub 2008 Aug 31. | |
| 21547086 | Background | Backes CH, Markham K, Moorehead P, Cordero L, Nankervis CA, Giannone PJ. Maternal preeclampsia and neonatal outcomes. J Pregnancy. 2011;2011:214365. doi: 10.1155/2011/214365. Epub 2011 Apr 4. |
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| ID | Term |
|---|---|
| D054098 | Thrombocytopenia, Neonatal Alloimmune |
| ID | Term |
|---|---|
| D013921 | Thrombocytopenia |
| D001791 | Blood Platelet Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| SGA - Control group |
| Other |
Data processing from Patient Medical Files |
|
| AGA-PIH Study group | Other | Monitoring PIH-related changes in the newborn |
|
| SGA-PIH Study group | Other | Monitoring PIH-related changes in the newborn |
|
| 9215266 | Background | de Zegher F, Francois I, van Helvoirt M, Van den Berghe G. Clinical review 89: Small as fetus and short as child: from endogenous to exogenous growth hormone. J Clin Endocrinol Metab. 1997 Jul;82(7):2021-6. doi: 10.1210/jcem.82.7.4007. No abstract available. |
| 26459642 | Background | Christensen RD, Yoder BA, Baer VL, Snow GL, Butler A. Early-Onset Neutropenia in Small-for-Gestational-Age Infants. Pediatrics. 2015 Nov;136(5):e1259-67. doi: 10.1542/peds.2015-1638. Epub 2015 Oct 12. |
| D000095542 | Cytopenia |
| D007232 | Infant, Newborn, Diseases |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |