Abstract
NP is a frequent finding in complicated pregnancies. It has been associated with intrauterine growth retardation (IUGR), diabetes and maternal hypertension. However it is still not clear whether the association with hypertension is the result of hypertension per-se or of IUGR. To determine the risk of NP in infants of HT mothers we analized the hematocrit values obtained from neonates born at the Hospital de Clinicas from January 1986 through July 1987.
The risk of NP in infants of HT was 12.6 times greater than the risk of the general population (95% Confidence limits(CL): 5.3-30.1; Chi = 5.7; p=.017). The risk of NP in IUGR was 6.05 (95%CL: .937-39.03; Chi= 1.891;p=.169). The risk of NP in HY+IUGR was 8.5 times the risk of NP in IUGR without HT(95%CL: 1.15-62.98; Chi=2.101;p<=. 15) and 53 times greater than the risk of the general population (95%CL:14.3-198.4;Chi=10.15 7 p=.001). Considering the incidence of NP in the population, the attributable risk (etiologic fraction) for HT is 5.9%.
These data show that maternal HT poses a significant risk for the development of NP, regardless of fetal growth.
Speculation: IUGR could represent the failure of chronic adaptative mechanisms that the fetus develops to compensate for altered placental blood flow.
We suggest that hematocrit values be obtained on all infants of HT mothers, regardless of growth status, in order to rule out NP.
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Mazzucchelli, M., Kurlat, I. & Sola, A. RISK OF NEONATAL POLYCYTHEMIA (NP) IN INFANTS OF HYPERTENSIVE MOTHERS (HT). Pediatr Res 26, 166 (1989). https://doi.org/10.1203/00006450-198908000-00043
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DOI: https://doi.org/10.1203/00006450-198908000-00043