DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20184277

Neurodevelopment and growth outcome at one year in babies born at term to mothers having pregnancy induced hypertension

Deepthi Pagali, Suneetha Bollipo, Srinivasa Vithal Rao Natta

Abstract


Background: Hypertensive disorder in pregnancy remains an important cause of perinatal morbidity and mortality. Being small for gestational age (SGA) may be associated with poor neurodevelopmental outcomes compared to being appropriate for gestational age (AGA). The aim of this paper is to evaluate neurodevelopmental scores as well as growth monitoring in SGA and AGA infants born at term to PIH mothers followed till one year of age.

Methods: This is a prospective, observational, hospital-based study, conducted in a tertiary care mother and child institute in Andhra Pradesh, South India.

Results: Two hundred babies born at term to PIH mothers are included in the study and are followed up over a period of 12 months. Data is analyzed using Statistical Package for Social Sciences (SPSS). Growth retardation is seen in 12 % of term, SGA and 3.5% of term, AGA babies. SGA babies have a statistically significant correlation (p value = 0.02) in physical growth compared to AGA babies. Neurodevelopmental delay is present in 30% of SGA babies and 5% of AGA babies. The association between SGA and neurodevelopmental disability is statistically significant (p value <0.01).

Conclusions: Pregnancy induced hypertension has a statistically significant effect on neurodevelopment and physical growth of a child when followed up to 12 months of age, in SGA babies, more so in VLBW babies. Early intervention programmes through medical, developmental, neuromotor, neurosensory interventions and other stimulation programs, might help in reducing the burden of the disease as well as improving the quality of life.

 


Keywords


AGA, Neurodevelopment, Pregnancy induced Hypertension, SGA, VLBW

Full Text:

PDF

References


Nelson SM, Greer IA. Hypertensive disorders of pregnancy: preventative-, immediate- and long-term management. 2006, Expert Rev Pharmacoecon Outcomes Res. 2006;6(5):541-54.

Allen VM, Joseph KS, Murphy KE, Magee LA, Ohlsson A. The effect of hypertensive disorders in pregnancy on small for gestational age and stillbirth: a population based study. BMC Pregnancy Childbirth. 2004;4:17.

Chappell LC, Enye S, Seed P, Briley AL, Poston L, Shennan AH. Adverse perinatal outcomes and risk factors for preeclampsia in women with chronic hypertension: a prospective study. Hypertension. 2008;51(4):1.

Bear LM. Early identification of infants at risk for developmental disabilities. Pediatr Clin North Am. 2004;51(3):685-701.

Cioni G, Inguaggiato E, Sgandurra G. Early intervention in neurodevelopmental disorders: underlying neural mechanisms. Developmental Medicine Child Neurol. 2016;58:61-6.

Frankenburg WK. The Denver approach to early case finding. In: Frankenburg WK, Emde RN, Sullivan JW, editors. Early identification of children at risk. New York: Plenum; 1985:135-158.

Amiel-Tison C, Grenier A. Neurological assessment during first year of life. New York: Oxford University Press; 1986:46-94.

Khadilkar VV, Khadilkar AV, Choudhury P, Agarwal KN, Ugra D, Shah NK. IAP growth monitoring guidelines for children from birth to 18 years. Indian Pediatr. 2007;44:187-97.

Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 2000;183(1):S1-S22.

Singh M. Care of the new born. New Delhi: Sagar Publications; 2015.

Haelterman E, Breart G, parisliado J, Pramaix M Chobroutsky C. Effect of uncomplicated chronic hypertension on the risk for small for gestational age birth. Am J Epidemol. 1997;145(8):689-95.

Eskenazi B, Fenster L, Sindey S, Eklin EP. Fetal growth retardation in infants of multiparous and nulliparous women with pre-eclampsia. Am J Obstet Gynecol. 1993;169:1112-8.

Nadkarni J, Bhal J, Parekh P. Prenatal outcome in pregnancy associated hypertension. Indian Pediatr. 2001;38:174-8.

Sridhar K, Bhatt BV, Srinivas. Growth pattern of low birth weight babies in the first year of life. Indian J Paediatr. 2002;69:485-8.

Chiswick MI. Prolonged rupture of membranes, pre-eclamptic toxaemia and respiratory distress syndrome. Arch Dis Child. 1976;51:674-9.

Chaudari S, Kulkarni S, Bharve S, Pandit AN, Sonak U, Nirmala S. Neurological sequelae in high risk infants: A three year follow up. Indian Paediatr. 1996;33:645-53.

Vohr BR, Wright LL, Dusick AM, Mele L, Verter J, Steichen JJ, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human development Neonatal Research Network, 1993-1994. Pediatr. 2000;105:1216-26.

Gutbrod T, Wolke D, Soehne B, Ohrt B, Riegel K. Effects of gestation and birth weight on the growth and development of very low birth weight small for gestational age infants: a matched group comparison. Arch Dis Child Fetal Neonatal Ed. 2000;82: F208-14.

Chaudhari S, Bhalerao MR, Chitale A, Pandit AN, Nene U. Pune low birth weight study: a six year follow up. Indian Pediatr.1999;36:669-76.

Illingworth RS. The development of the infant and young child: Normal and abnormal, Edinburgh, Churchil living stone; 1991.