(647) Neonatal outcomes in individuals with periviable pre-eclampsia.

To compare neonatal outcomes in pregnancies complicated by pre-eclampsia versus patients without pre-eclampsia between 22w0d and 25w0d.

Study Design:

Retrospective cohort study utilizing the Registry of Obstetrical Determinants of Neonatal Survival (ODNS) of pregnancies with delivery between 22w0d-25w0d.  Individuals with preeclampsia were compared to individuals delivered during the same gestational age without preeclampsia. The primary outcome is a composite measure of neonatal outcomes which includes neonatal death (death within 120 days of delivery), seizures, necrotizing enterocolitis requiring surgery, oxygen dependence at discharge or at 120 days of age, Grade III or IV retinopathy of prematurity and Grade III/IV CNS hemorrhage. Multivariate analysis was performed with Pearson Chi-squared tests, fisher’s exact test to analyze categorical variables and two tailed test to analyze continuous variables.

Results:

A total of 339 pregnancies met inclusion criteria. 18(5.3%) was delivered for severe pre-eclampsia while 321(94.75%) delivered for other indications. Both groups were similar in terms of umbilical pH, estimated gestational age, number of days on a ventilator and number of days spent in the NICU. There was a significant difference in the median birth weight of the pre-eclampsia group compared to the non-pre-eclampsia group (519grams versus 614gram, P=0.016) In the pre-eclampsia group, 6(33.3%) of neonates were alive at  120 days of birth, compared to 121(37.7%) in the non-pre-eclampsia group(p= 0.806). The composite neonatal outcome was similar between both groups (16(88.%) for preE vs 274( 84.8%), p= 0.638). 

Conclusion:

Infants born in the periviable period secondary to preeclampsia experience similar neonatal outcomes in comparison to other indications for preterm delivery.