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Objective <p>To investigate the impact and risk factors of preeclampsia on neonatal brain injury.</p> Methods <p>This study employed a retrospective cohort analysis, encompassing 1062 pregnant women and their newborns delivered at Ningbo Women and Children's Hospital between January 2018 and June 2024. The cohort included 531 cases in the preeclampsia group and 531 in the control group without hypertensive disorders. Based on cranial ultrasound and MRI results, neonates in the preeclampsia group were categorized into those with brain injury (Group A, 74 cases) and those without (Group B, 457 cases). Multivariable logistic stepwise regression analysis was conducted to identify risk factors for neonatal brain injury in neonates born to mothers with preeclampsia.</p> Results <p>①The prevalence of neonatal brain injury was notably higher in the preeclampsia group compared to the control group (13.9% vs 3.6%, P &lt; 0.05). ②Compared to group B, mothers in group A exhibited an earlier onset of hypertension, a shorter gestational age at pregnancy termination, and a longer interval from hypertension diagnosis to pregnancy termination [ (30.68±4.59) weeks vs (34.63±3.22) weeks, (34.41±2.68）weeks vs（36.37±2.11）weeks, IQR=2.5（95%CI；1-6）weeks vs IQR=1 (95%CI：0-2) weeks, P &lt;0.05]. They also had significantly higher incidences of Pre-pregnancy obesity, preeclampsia with severe feature, fetal growth restriction, maternal or fetal vascular malperfusion, abnormal umbilical artery systolic/diastolic ratio, and cesarean sections (23.4%vs12.9%, 60.8%vs35.7%, 24.3%vs15.1%, 37.8%vs20.6%, 13.5%vs3.9%, 81.1%vs69.8%, P＜0.05). The Apgar scores at 1 and 5 minutes, as well as the birth weight, were significantly lower in neonates from Group A compared to those in Group B [（8.43±1.07）vs (8.86±0.53)，(9.54±0.73) vs (9.88±0.42)，(2278±777) g vs（2719±637）g，P＜0.05].③ Risk factors for neonatal brain injury in preeclampsia include preeclampsia with severe feature, hypertension diagnosis-to-delivery interval exceeding 3.5 weeks, delivery before 35.5 weeks of gestation, and an Apgar score below 8.5 at 1 minute. ④ Risk factors for neonatal brain injury in preeclampsia without severe feature include pre-pregnancy obesity, hypertension diagnosis-to-delivery interval exceeding 1.5 weeks, delivery before 37.5 weeks of gestation, and an Apgar score below 7.5 at 1 minute. ⑤ Risk factors for neonatal brain injury in preeclampsia with severe feature include hypertension diagnosis-to-delivery interval exceeding 3.5 weeks, delivery before 35.5 weeks of gestation,and maternal or fetal vascular malperfusion. </p> Conclusion <p>Preeclampsia elevates the risk of neonatal brain injury in offspring. Enhancing prenatal management, slowing disease progression, prolong gestational duration, and improving the 1-minute Apgar score may mitigate this risk.</p>

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Risk factors for neonatal brain injury in neonates born to mothers with preeclampsia: a retrospective study

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  • 发表日期：

    2026年2月7日

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  • Chunbo Shi,
  • Jinliang Chen,
  • Xianhu Fu,
  • Aner Chen

摘要

Objective

To investigate the impact and risk factors of preeclampsia on neonatal brain injury.

Methods

This study employed a retrospective cohort analysis, encompassing 1062 pregnant women and their newborns delivered at Ningbo Women and Children's Hospital between January 2018 and June 2024. The cohort included 531 cases in the preeclampsia group and 531 in the control group without hypertensive disorders. Based on cranial ultrasound and MRI results, neonates in the preeclampsia group were categorized into those with brain injury (Group A, 74 cases) and those without (Group B, 457 cases). Multivariable logistic stepwise regression analysis was conducted to identify risk factors for neonatal brain injury in neonates born to mothers with preeclampsia.

Results

①The prevalence of neonatal brain injury was notably higher in the preeclampsia group compared to the control group (13.9% vs 3.6%, P < 0.05). ②Compared to group B, mothers in group A exhibited an earlier onset of hypertension, a shorter gestational age at pregnancy termination, and a longer interval from hypertension diagnosis to pregnancy termination [ (30.68±4.59) weeks vs (34.63±3.22) weeks, (34.41±2.68）weeks vs（36.37±2.11）weeks, IQR=2.5（95%CI；1-6）weeks vs IQR=1 (95%CI：0-2) weeks, P <0.05]. They also had significantly higher incidences of Pre-pregnancy obesity, preeclampsia with severe feature, fetal growth restriction, maternal or fetal vascular malperfusion, abnormal umbilical artery systolic/diastolic ratio, and cesarean sections (23.4%vs12.9%, 60.8%vs35.7%, 24.3%vs15.1%, 37.8%vs20.6%, 13.5%vs3.9%, 81.1%vs69.8%, P＜0.05). The Apgar scores at 1 and 5 minutes, as well as the birth weight, were significantly lower in neonates from Group A compared to those in Group B [（8.43±1.07）vs (8.86±0.53)，(9.54±0.73) vs (9.88±0.42)，(2278±777) g vs（2719±637）g，P＜0.05].③ Risk factors for neonatal brain injury in preeclampsia include preeclampsia with severe feature, hypertension diagnosis-to-delivery interval exceeding 3.5 weeks, delivery before 35.5 weeks of gestation, and an Apgar score below 8.5 at 1 minute. ④ Risk factors for neonatal brain injury in preeclampsia without severe feature include pre-pregnancy obesity, hypertension diagnosis-to-delivery interval exceeding 1.5 weeks, delivery before 37.5 weeks of gestation, and an Apgar score below 7.5 at 1 minute. ⑤ Risk factors for neonatal brain injury in preeclampsia with severe feature include hypertension diagnosis-to-delivery interval exceeding 3.5 weeks, delivery before 35.5 weeks of gestation,and maternal or fetal vascular malperfusion.

Conclusion

Preeclampsia elevates the risk of neonatal brain injury in offspring. Enhancing prenatal management, slowing disease progression, prolong gestational duration, and improving the 1-minute Apgar score may mitigate this risk.