453 - Hematological Outcomes in Preterm Infants Born Less than 35 weeks to Mothers with Preeclampsia

Poster Number: 453
Publication Number: 453.1280

Background: Preeclampsia, a condition characterized by elevated blood pressure and organ dysfunction, affects approximately 4% of pregnancies worldwide [1-2]. While extensive research is available on maternal health, its effects on premature neonates have not been well studied.

Objective: To study the effects of preeclampsia on hematological parameters in preterm infants.

Design/Methods: This is a retrospective cohort study from a single tertiary medical center (2015 to 2020). We compared hematologic parameters on admission of 208 neonates born to mothers with preeclampsia matched to 378 controls. The gestational age ranged from 23 to 34 weeks: Moderately preterm (32 to 34) with 93 PreE and 158 control, Very preterm (28 to < 32) with 88 PreE and 165 control, and Extremely preterm ( < 28) with 27 PreE and 55 control. Data on hemoglobin (Hgb), white blood cells (WBC), and platelets (PLT) were collected from admission complete blood counts. Additional data including number of transfusions of platelet and red blood cells were also reviewed. Data were analyzed with two-tailed t-tests. Significance was defined as p< 0.05.

Results: For the entire cohort, the means for preeclampsia (PreE) and control were: Hgb 16.3 and 15.6 gm/dl; WBC 8.1 and 11.4 k/ul; PLT 193.4 and 216.7 k/ul. All results were significant. Similar trends were observed with sub-group analysis. Results in the Moderately preterm group were all significant: Hgb 16.7 (PreE) and 16.1 gm/dl (control); WBC 10.0 (PreE) and 11.6 k/ul (control); PLT 206.1 (PreE) and 224.2 k/ul (control). Results in the Very preterm group were significant with exception of PLT (P = 0.059): Hgb 16.3 (PreE) and 15.6 gm/dl (control); WBC 7.1 (PreE) and 10.2 k/ul (control); PLT 191.8 (PreE) and 210 k/ul (control). Results in the Extremely preterm group were all significant: Hgb 15.1 (PreE) and 13.9 gm/dl (control); WBC 4.3 (PreE) and 14.7 k/ul (control); PLT 153.6 (PreE) and 213.6 k/ul (control). The number red blood cell transfusions was lower for the PreE subjects only in the Very preterm group (0.19 vs. 0.6).

Conclusion(s): Premature infants born to mothers with preeclampsia exhibited a pattern of higher hemoglobin, lower WBC, and lower PLT. When stratified by gestational age, these findings more pronounced in the extremely preterm group, but diminished as gestational age increased. There was no difference in the number of transfusions except for RBC transfusions in the Very preterm group. The overall pattern demonstrates that the impact of preeclampsia on hematological profiles is more pronounced in the most preterm infants.