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Birth weight and infant growth after a hypertensive pregnancy. Is the gestation or the disease more important?
  1. A Green1,2,
  2. P Loughna1,2,
  3. F Brougton Pipkin1
  1. 1Nottingham University, Nottingham, UK
  2. 2Nottingham University Hospitals, Nottingham, UK

Abstract

Hypertension affects up to 10% of all pregnancies. Small babies are up to 1.6 times more likely in a hypertensive pregnancy (Allen, Joseph et al. 2004).

Materials & methods Nottingham City Hospital is a large tertiary Obstetrics Unit with approximately 6000 deliveries per year. Since December 2008 we established a follow-up clinic for women with hypertension in pregnancy (stringently defined pre-eclampsia (PE), gestational hypertension (GH) and essential hypertension (EH) with or without superimposed PE).

Anthropological measurements were carried out on the infants of the women attending the clinic. Weight, length, head circumference and skin fold thickness were all measured. Birth centiles and z scores were calculated.

Results 195 women with singleton live births have been seen. Seven sets twins and four women with intrauterine fetal deaths were excluded from analysis. There were 32 preterm births (26/100 PE, 2/687 GH, 1/20 EH + no PE, 3/5 EH + PE). The mean gestation at birth was significantly lower in the PE and EH group compared to the GH and GH + PE groups (p=0.001). There was no difference in birth weight centile between the groups or z scores for pre-term and term deliveries between the groups. There was also no difference in the weight mean weight at 6 weeks postnatlly however the babies born to pre-eclamptic mothers showed a much faster growth velocity than the other groups (catch-up growth).

Conclusions The birthweight and weight at 6 weeks was no different between the babies of mothers with different types of hypertension. However the growth velocity was much faster in the PE group than the other groups supporting the hypothesis of catch up growth.

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