Neonatal Hematological Abnormalities Associated with Maternal Pre-eclampsia at Birth
DOI:
https://doi.org/10.36283/PJMD13-1/007Keywords:
Hematologic Diseases, Neonates, Pre-eclampsiaAbstract
Background: Pre-eclampsia (PE) can cause hematological abnormalities that can further exacerbate the existing morbidity in newborns. This study aimed to investigate neonatal hematological abnormalities associated with maternal pre-eclampsia at the time of birth.
Methods: This cross-sectional was conducted from January 2023 to July 2023, involving 122 neonates born at the Department of Pediatric Medicine, Sohail Trust Hospital in Karachi, Pakistan. It analyzed neonates of either gender, aged from birth to 24 hours of life, and born to pre-eclamptic mothers, and their demographic details were recorded. At delivery, 2 ml of umbilical venous blood was collected by a trained pediatric nurse and then sent to the institutional laboratory. Hematological changes like leukopenia, thrombocytopenia, or neutropenia were noted. To assess the influence of various factors on hematological outcomes, chi-square tests were applied, with a significance threshold set at p<0.05.
Results: In a total of 122 neonates, the mean age was 8.14±6.49 hours. The mean gestational age was 38.87±3.15 weeks. There were 68 (55.7%) neonates who were male. Low birth weight (LBW) was less than 2500 grams in 45 (36.9%) newborns. Thrombocytopenia, leukopenia, and neutropenia were identified in 32 (26.2%), 25 (20.5%), and 23 (18.9%) neonates respectively. Stratification of leukopenia concerning study variables revealed that gestational age and LBW had a significant association (p=0.0036, p=0.0072) with leukopenia. Moreover, neutropenia also had an association with LBW (p<0.0001).
Conclusion: These findings underscore the importance of early hematological screening for neonates born to pre-eclamptic mothers to facilitate timely diagnosis and care.
References
World health organization. Neonatal mortality. 2021. Available at: https://www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-child-mortality-report-2021
Khan A, Kinney MV, Hazir T, Hafeez A, Wall SN, Ali N, et al. Newborn survival in Pakistan: a decade of change and future implications. Health Policy Plan. 2012;27(Suppl 3):iii72–iii87. doi: 10.1093/heapol/czs047
Mou AD, Barman Z, Hasan M, Miah R, Hafsa JM, Trisha AD, et al. Prevalence of preeclampsia and the associated risk factors among pregnant women in Bangladesh. Sci Rep. 2021;11(1):21339. doi:10.1038/s41598-021-00839-w
Osungbade KO, Ige OK. Public health perspectives of preeclampsia in developing countries: implication for health system strengthening. J Pregnancy. 2011;2011. doi:10.1155/2011/481095
Jung E, Romero R, Yeo L, Nardhy G, Piya C, Adithep J, et al. The etiology of preeclampsia. Am J Obstet Gynecol. 2022;226(2S):S844-S866. doi:10.1016/j.ajog.2021.11.1356
Fox R, Kitt J, Leeson P, Aye CYL, Lewandowski AJ. Preeclampsia: Risk Factors, Diagnosis, Management, and the Cardiovascular Impact on the Offspring. J Clin Med. 2019;8(10):1625. doi:10.3390/jcm8101625
Vigil-De Gracia P, Vargas C, Sánchez J, Collantes-Cubas J. Preeclampsia: Narrative review for clinical use. Heliyon. 2023;9(3):e14187. doi:10.1016/j.heliyon.2023.e14187
Uzunov AV, Secara DC, Mehedințu C, Cîrstoiu MM. Preeclampsia and neonatal outcomes in adolescent and adult patients. J Med Life. 2022;15(12):1488-1492. doi:10.25122/jml-2022-0264
Atamamen TF, Naing NN, Oyetunji JA, Wan-Arfah N. Systematic literature review on the neonatal outcome of preeclampsia. Pan Afr Med J. 2022;41:82. doi:10.11604/pamj.2022.41.82.31413
Zhang N, Tan J, Yang H, Khalil RA. Comparative risks and predictors of preeclamptic pregnancy in the Eastern, Western and developing world. Biochem Pharmacol. 2020;182:114247. doi:10.1016/j.bcp.2020.114247
Ceyhan T, Beyan C, Baser I, Kaptan K, Güngör S, Ifran A. The effect of preeclampsia on complete blood count, platelet count and mean platelet volume. Ann Hematol. 2006;85(5):320-322. doi:10.1007/s00277-006-0091-7
Sivakumar S, Bhat BV, Badhe BA. Effect of pregnancy induced hypertension on mother and their babies. Indian J Pediatr. 2007;74:623-625. doi:10.1007/s12098-007-0110-2
Mouzinho A, Rosenfeld CR, Sanchez PJ, Risser R. Effect of maternal hypertension on neonatal neutropenia and risk of nosocomial infection. Pediatrics. 1992; 90:430–435.
Mosayebi Z, Nariman S, Hosseini L, Movahedian AH. Evaluation of laboratory disorders in admitted neonates in nicu who were born to preeclamptic mothers. J ComprPed. 2013;4(4):194-9. doi:10.17795/compreped-12755
Bayoumi MAA, Ali AAH, Hamad SG, Ali AAM, Elmalik EE, Elkalaf MIR, et al. Effect of Maternal Preeclampsia on Hematological Profile of Newborns in Qatar. Biomed Res Int. 2020;2020:7953289. doi:10.1155/2020/7953289
Kiran S, Bhaskar G, Jayashree N. A Study of Thrombocytopenia in Sick Neonates in a Tertiary Care Centre. Sch J App Med Sci, 2017;5(9B):3609-3616. doi: 10.36347/sjams.2017.v05i09.027
Harms K., Rath W., Herting E., Kuhn W. Maternal hemolysis, elevated liver enzymes, low platelet count, and neonatal outcome. American Journal of Perinatology. 1995;12(1):1–6. doi: 10.1055/s-2007-994387
Eeltink CM, van Lingen RA, Aarnoudse JG, Derks JB, Okken A. Maternal haemolysis, elevated liver enzymes and low platelets syndrome: specific problems in the newborn. European Journal of Pediatrics. 1993;152(2):160–163. doi: 10.1007/BF02072496.
Bhat YR, Cherian CS. Neonatal thrombocytopenia associated with maternal pregnancy induced hypertension. Indian Journal of Pediatrics. 2008;75(6):571–573. doi: 10.1007/s12098-008-0110-x
Mouna K, Doddagowda SM, Junjegowda K, Krishnamurthy L. Changes in Haematological Parameters in Newborns Born to Preeclamptic Mothers - A Case Control Study in a Rural Hospital. J Clin Diagn Res. 2017;11(7):EC26-EC29. doi:10.7860/JCDR/2017/29137.10303
Okoye HC, Eweputanna LI, Korubo KI, Ejele OA. Effects of maternal hypertension on the neonatal haemogram in southern Nigeria: A case-control study. Malawi Med J. 2016;28(4):174-178. doi:10.4314/mmj.v28i4.5
Tiruneh T, Kiros T, Getu S. Hematological reference intervals among full-term newborns in Ethiopia: a cross-sectional study. BMC Pediatr. 2020;20(1):417. doi:10.1186/s12887-020-02320-5
Nelson KM, Irvin-Choy N, Hoffman MK, Gleghorn JP, Day ES. Diseases and conditions that impact maternal and fetal health and the potential for nanomedicine therapies. Adv Drug Deliv Rev. 2021;170:425-438. doi:10.1016/j.addr.2020.09.013
Phipps EA, Thadhani R, Benzing T, Karumanchi SA. Pre-eclampsia: pathogenesis, novel diagnostics and therapies [published correction appears in Nat Rev Nephrol. 2019 Jun;15(6):386]. Nat Rev Nephrol. 2019;15(5):275-289. doi:10.1038/s41581-019-0119-6
Dziegiel MH, Krog GR, Hansen AT, Olsen M, Lausen B, Norgaard LN, et al. Laboratory monitoring of mother, fetus, and newborn in hemolytic disease of fetus and newborn. Transfus Med Hemother. 2021;48(5):306-315. doi:10.1159/000518782
Additional Files
Published
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Medicine and Dentistry
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access article distributed under the terms of the CreativeCommons Attribution License (CC BY) 4.0 https://creativecommons.org/licenses/by/4.0/