Poster Session 2
Category: Prematurity
Poster Session 2
Grace M. DiGiovanni, BA (she/her/hers)
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Sara E. Edwards, MD (she/her/hers)
Fellow
Division of Maternal-Fetal Medicine, Icahn School of Medicine at Mount Sinai
New York, New York, United States
Nicola F. Tavella, CPH, MPH (he/him/his)
Clinical Research Program Director
Division of Maternal-Fetal Medicine, Icahn School of Medicine, Icahn School of Medicine at Mount Sinai Hospital
New York, New York, United States
Sunidhi Singh, MD
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Camila Johanek, MS
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Sarriyah Hanif, MD
Resident physician
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Gabriele Baptiste
Icahn School of Medicine
Icahn School of Medicine, New York, United States
Dayana Mirzaliev, MPH
Clinical Research Coordinator
Division of Maternal-Fetal Medicine, Icahn School of Medicine at Mount Sinai
New York, New York, United States
Monica J. Patel, MPH
Clinical Research Coordinator
Division of Maternal-Fetal Medicine, Icahn School of Medicine at Mount Sinai
New York, New York, United States
Alexandra N. Mills, MD (she/her/hers)
Resident Physician
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Daniel Katz, MD
Associate Professor, Anesthesiology
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Chelsea A. DeBolt, MD, MSCR
Assistant Professor
Division of Maternal-Fetal Medicine, Icahn School of Medicine at Mount Sinai
New York, New York, United States
Angela T. Bianco, MD
Professor and Division Director, Maternal-Fetal Medicine
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Betamethasone administration for pregnant patients at risk of preterm delivery has been shown to improve neonatal outcomes. Research also suggests that neonates who develop in a hypertensive environment may clinically differ from those born to patients without hypertension. There are limited studies analyzing how hypertensive disorders of pregnancy (HDP) influence neonatal outcomes after betamethasone administration. We hypothesized that there would be no difference in neonatal respiratory outcomes after betamethasone administration between patients with and without HDP.
Study Design:
This was a retrospective chart study of all patients delivering at a single academic institution in New York City from January 1, 2013 - December 31, 2023 who received two doses of betamethasone prior to delivery and had a diagnosis of gestational hypertension, preeclampsia with or without severe features, eclampsia, or HELLP. We assessed electronic medical records for clinical and demographic data. Our primary outcome was a neonatal respiratory composite (transient tachypnea of the newborn, respiratory distress syndrome, use of CPAP for > 12 hours, oxygen for > 24 hours, intubation, and/or surfactant). Multivariable logistic regression models controlling for potential confounders examined associations of HDP with neonatal respiratory outcomes.
Results:
2,638 patients were identified, of which 675 had HDP (Table 1). Patients with HDP delivered neonates at lower birth weights and earlier gestational ages and were more likely to have other comorbidities (Table 1). After controlling for confounders, neonates born to patients with any HDP had a higher likelihood of requiring CPAP for > 12 hours (Table 2). Neonates of patients with pre-eclampsia with severe features, eclampsia, or HELLP had a higher likelihood of developing RDS and TTN, and requiring CPAP for >12 hours and oxygen for > 24 hours (Table 2).
Conclusion:
Neonates born to patients with HDP, particularly severe forms, experienced worse respiratory outcomes than their counterparts, despite betamethasone administration.