Abstract: SA-PO043

Preeclampsia: Long-Term Effects on Pediatric Social Disability

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Mercurio, Carmen, Universidad Complutense Madrid, Madrid, Spain
  • Rodriguez benitez, Patrocinio, Hospital General Universitario "Gregorio Marañón", Madrid, Spain
  • Elero, Maria rosa, Hospital Genral "Gregorio Marañón", Madrid, Spain
  • Tejedor jorge, Alberto, Fundación para la Investigación Biomédica del Hospital General Universitario Gregorio Marañón, Madrid, Spain
Background

Preclampsia affects up to 10% of pregnancies worldwide and is one of the main causes of fetal morbi-mortality. Although its effects on maternal renal function are well established and have been attempted to relate to delayed pediatric development, its long-term effects on the child have not yet been quantified.
Objectives. Our aim is to evaluate whether the preclampsia’s severity and its obstetric management correlate to fetal morbidity and the degree of developmental delay in these infants.

Methods

This is an observational and descriptive study performed on a population of 96 women who were diagnosed with severe preclampsia at Hospital General Universitario Gregorio Marañón between 2007 and 2014, and their 111 children.
To assess the mother, we gathered data from her medical history, blood analytics, medical management of the preeclampsia, evolution of renal function at 12 weeks and discharge from nephrology. To assess the children, we collected information of the pregnancy and delivery, as well as main diagnoses at birth. We used the Pediatric Evaluation of Disability Inventory in its computerized adaptive test version (PEDI-CAT) to study neurodevelopment,the TNO-AZL Preschool children Quality of Life (TAPQOL) to estimate quality of life, and M-CHAT (Modified Checklist for Autism in Toddlers) for Autism screening.

Results

Preclampsias with greater impact on maternal fidney function correlated with higher periventricular-intraventricular hemorrhage rates in the newborn. In terms of functional activity, PEDI-CAT percentiles were consistently lower in the Social/Cognitive domain, and these were associated to both lower maternal IgG levels, to low maternal platelet levels and maternal high urinary osmolality.
High rates of maternal proteinuria were associated to greater risk of perinatal death. The presence of neonatal necrotizing enterocolitis was also associated with lower Social/Cognitive percentiles.

Conclusion

A connection between preclampsia and poor social/cognitive outcomes exists. This association is stronger when the mother has thrombocytopenia and increased ADH. Renal involvement and proteinuria are associated with higher morbi-mortality attributable to prematurity but not with alterations in subsequent social-cognitive development. ADH deficit in the newborn could have implications or could be responsible for a behavior of social retraction.