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Pediatrics. 2016 Mar;137(3):e20152163. doi: 10.1542/peds.2015-2163. Epub 2016 Feb 18.

Placental Complications and Bronchopulmonary Dysplasia: EPIPAGE-2 Cohort Study.

Author information

1
INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Obstetrical, Perinatal and Pediatric Epidemiology Team, Paris, France; DHU Risk in Pregnancy, Cochin Hotel-Dieu Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France; heloise.torchin@inserm.fr.
2
INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Obstetrical, Perinatal and Pediatric Epidemiology Team, Paris, France; DHU Risk in Pregnancy, Cochin Hotel-Dieu Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France; Unité de Recherche Clinique - Centre d' Investigation Clinique;
3
INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Obstetrical, Perinatal and Pediatric Epidemiology Team, Paris, France; DHU Risk in Pregnancy, Cochin Hotel-Dieu Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France; Maternité Port-Royal, and.
4
Maternite Regionale Universitaire, Neonatology, Nancy, France; and.
5
Jeanne de Flandre Hospital, Department of Neonatology CHRU de Lille, Lille Cedex, France.
6
INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Obstetrical, Perinatal and Pediatric Epidemiology Team, Paris, France;
7
DHU Risk in Pregnancy, Cochin Hotel-Dieu Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France; Service de Médecine et Réanimation Néonatales de Port-Royal, Assistance Publique, Hôpitaux de Paris, Hôpital Cochin, Paris, France;

Abstract

OBJECTIVE:

To investigate the relationship between placenta-mediated pregnancy complications and bronchopulmonary dysplasia (BPD) in very preterm infants.

METHODS:

National prospective population-based cohort study including 2697 singletons born before 32 weeks' gestation. The main outcome measure was moderate to severe BPD. Three groups of placenta-mediated pregnancy complications were compared with no placenta-mediated complications: maternal disorders only (gestational hypertension or preeclampsia), fetal disorders only (antenatal growth restriction), and both maternal and fetal disorders.

RESULTS:

Moderate to severe BPD rates were 8% in infants from pregnancies with maternal disorders, 15% from both maternal and fetal disorders, 23% from fetal disorders only, and 9% in the control group (P < .001). When we adjusted for gestational age, the risk of moderate to severe BPD was greater in the groups with fetal disorders only (odds ratio [OR] = 6.6; 95% confidence interval [CI], 4.1-10.7), with maternal and fetal disorders (OR = 3.7; 95% CI, 2.5-5.5), and with maternal disorders only (OR = 1.7; 95% CI, 1.0-2.7) than in the control group. When we also controlled for birth weight, the relationship remained in groups with fetal disorders only (OR = 4.2; 95% CI, 2.1-8.6) and with maternal and fetal disorders (OR = 2.1; 95% CI, 1.1-3.9).

CONCLUSIONS:

Placenta-mediated pregnancy complications with fetal consequences are associated with moderate to severe BPD in very preterm infants independently of gestational age and birth weight, but isolated maternal hypertensive disorders are not. Fetal growth restriction, more than birth weight, could predispose to impaired lung development.

PMID:
26908662
PMCID:
PMC4771126
[Available on 2017-03-01]
DOI:
10.1542/peds.2015-2163
[Indexed for MEDLINE]
Free PMC Article

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