The following is a summary of “Risk of Adverse Neonatal Events in Pregnancies Complicated by Severe Maternal Morbidity,” published in the June 2024 issue of Pediatrics by Ukah et al.
To investigate the risk of adverse neonatal events following pregnancies complicated by severe maternal morbidity, the researchers conducted a comprehensive population-based cohort study. The analysis included deliveries in Quebec, Canada, from 2006 to 2021. The primary exposure of interest was severe maternal morbidity, encompassing life-threatening conditions such as severe hemorrhage, cardiac complications, and eclampsia. The adverse neonatal outcomes assessed were very preterm birth (gestational age <32 weeks), bronchopulmonary dysplasia, hypoxic-ischemic encephalopathy, and neonatal death. The study group employed log-binomial regression models to estimate adjusted relative risks (RR) and 95% CI for the association between severe maternal morbidity and these adverse neonatal outcomes.
The study encompassed 1,199,112 deliveries, of which 29,992 (2.5%) were complicated by severe maternal morbidity, and 83,367 (7.0%) resulted in adverse neonatal events. They found that severe maternal morbidity was associated with a 2.96-fold increase in the risk of adverse neonatal events compared to cases without morbidity (95% CI 2.90-3.03). Notably, the highest associations were observed in mothers who required assisted ventilation (RR 5.86, 95% CI 5.34-6.44), experienced uterine rupture (RR 4.54, 95% CI 3.73-5.51), or had cardiac complications (RR 4.39, 95% CI 3.98-4.84). Furthermore, severe maternal morbidity was linked to a greater than threefold increase in the risk of neonatal death and hypoxic-ischemic encephalopathy and a more than tenfold increase in the risk of very preterm birth and bronchopulmonary dysplasia.
In conclusion, the findings highlight that severe maternal morbidity significantly elevates the risk of adverse neonatal events. This underscores the necessity for improved prevention strategies for severe maternal morbidity to mitigate the burden of severe neonatal morbidity and enhance neonatal health outcomes.
Source: sciencedirect.com/science/article/abs/pii/S002234762400252X