RESUMO
ResumenIntroducción: El síndrome de HELLP es un grave trastorno hipertensivo del embarazo con importantes problemas neonatales en los hijos de las madres afectadas. El objetivo de este trabajo fue conocer las características de estos neonatos y su evolución.Métodos: Se llevó a cabo un estudio observacional descriptivo y retrospectivo de los neonatos hijos de madre con síndrome de HELLP, nacidos en un hospital universitario entre el 1° de enero de 2008 y el 31 de diciembre de 2013. Se estudiaron 33 neonatos procedentes de 28 gestaciones (cinco gemelares). Se realizó un análisis descriptivo y comparativo entre grupos, y posteriormente un análisis de multivarianza de factores asociados con la mortalidad dentro de la serie.Resultados: De 33 recién nacidos estudiados (2.2/1,000 recién nacidos totales), dos fueron mortinatos (6.1% del total) y cuatro fallecieron tras el nacimiento (12.9% de los neonatos vivos), con una mortalidad perinatal total del 18.2%; 28 neonatos terminaron la gestación antes de la semana 37 (84.8%) y 11 antes de la semana 32 (33.3%); siete neonatos pesaron menos de 1,500 g (cuatro de ellos menos de 1,000 g). De los 31 recién nacidos vivos, 13 neonatos tenían peso menor al percentil 10 para su edad gestacional (41.9%), 20 precisaron reanimación neonatal (64.5%) y 14 presentaban leucopenia neonatal (45.2%). En la regresión logística final, la mortalidad neonatal se asoció con la gran prematuridad, independientemente del bajo peso, leucopenia o necesidad de reanimación neonatal.Conclusiones: Los hijos de madre con síndrome de HELLP presentan elevada mortalidad asociada con la alta prematuridad, independientemente de la presencia de leucopenia, bajo peso para edad gestacional o necesidad de reanimación neonatal.
AbstractBackground: HELLP syndrome is a serious hypertensive disorder of pregnancy with important neonatal problems in the newborn. The objective of this work was to determine the characteristics of these infants and its neonatal evolution.Methods: A retrospective observational study of all newborns of mothers with HELLP syndrome born in a university hospital between January 1, 2008 and December 31, 2013 was carried out. Thirty-three infants from 28 pregnancies (five twin gestations) were studied. A descriptive and comparative analysis between groups and a multivariate analysis of factors associated with mortality in the series took place.Results: Of 33 newborns studied (2.2 newborns/1,000 infants total), two were stillbirths (6.1% of the total) and four died after birth (12.9% of live neonates) with overall perinatal mortality of 18.2%. Pregnancies in 28 infants ended before 37 weeks (84.8%) and 11 pregnancies ended before week 32 (33.3%). Seven infants weighed < 1500 g (four weighed <1000 g). Of the 31 live births, 13 infants were in a <10th percentile weight for gestational age (41.9%), 20 needed neonatal resuscitation (64.5%) and 14 had leukopenia at birth (45.2%). In the final logistic regression, neonatal mortality was associated with extreme prematurity regardless of underweight, leukopenia and/or need for neonatal resuscitation.Conclusions: Children of mothers with HELLP syndrome have a high mortality associated with extreme prematurity, independent of the presence of leukopenia, low weight for gestational age and need for neonatal resuscitation.
RESUMO
BACKGROUND: HELLP syndrome is a serious hypertensive disorder of pregnancy with important neonatal problems in the newborn. The objective of this work was to determine the characteristics of these infants and its neonatal evolution. METHODS: A retrospective observational study of all newborns of mothers with HELLP syndrome born in a university hospital between January 1, 2008 and December 31, 2013 was carried out. Thirty-three infants from 28 pregnancies (five twin gestations) were studied. A descriptive and comparative analysis between groups and a multivariate analysis of factors associated with mortality in the series took place. RESULTS: Of 33 newborns studied (2.2 newborns/1,000 infants total), two were stillbirths (6.1% of the total) and four died after birth (12.9% of live neonates) with overall perinatal mortality of 18.2%. Pregnancies in 28 infants ended before 37 weeks (84.8%) and 11 pregnancies ended before week 32 (33.3%). Seven infants weighed<1500g (four weighed <1000g). Of the 31 live births, 13 infants were in a <10th percentile weight for gestational age (41.9%), 20 needed neonatal resuscitation (64.5%) and 14 had leukopenia at birth (45.2%). In the final logistic regression, neonatal mortality was associated with extreme prematurity regardless of underweight, leukopenia and/or need for neonatal resuscitation. CONCLUSIONS: Children of mothers with HELLP syndrome have a high mortality associated with extreme prematurity, independent of the presence of leukopenia, low weight for gestational age and need for neonatal resuscitation.