Hypertensive disorders of pregnancy represent the leading cause of perinatal morbidity and mortality in developing countries. Thus, the aim of this study was to evaluate the factors associated with mortality in newborns of hypertensive mothers. This is a prospective descriptive study with analytical aims, which collected 89 newborns of hypertensive mothers in the obstetric gynecology and neonatology departments of Panzi GRH from February 20, 2021 to May 20, 2022. Blood sampling from the umbilical artery was carried out in the delivery room, and biochemical analysis was performed using the Edan device. We collected 86 samples among which metabolic acidosis accounted for 33.7%, respiratory acidosis 32.6%, 27.9% mixed acidosis, pH ≤ 7.20 37.2%. Respiratory distress (p = 0.001), Apgar score at 5th minute (p = 0.020), resuscitation at birth (p = 0.001) are statistically associated with pH ≤ 7.20. The risk of newborn death was associated with a history of abortion in the mothers, with a risk multiplied by (HR = 2.73), less than 4 prenatal consultation (PNC) during pregnancy (HR = 2.96), antenatal corticosteroid therapy (HZ = 7.11), prematurity (HZ = 7.19), low birth weight (HR = 8.63), resuscitation of newborns (HR = 8.59), transfer to neonatology (HR = 7.05) and presence of complications in newborns (HR = 16.01). Mortality of newborns born to hypertensive mothers is associated with a history of maternal abortion, low birth weight, resuscitation in the delivery room, transfer to neonatology, gestational age and complications during hospitalization in neonatology. Since respiratory distress is associated with severe acidosis, systematic analysis of pH and blood gases at the umbilical cord remains necessary for neonatal management.
Cite this paper
Bidorho, N. F. , Mwilo, M. , Mwindja, N. L. , Mulindwa, J. , Bulambo, H. , Ntagereka, E. M. , Mukanga, O. , Tudiakwile, L. K. and Muhandule, A. B. (2023). Factors Associated with Mortality of Newborns of Hypertensive Mothers in Bukavu, Democratic Republic of the Congo. Open Access Library Journal, 10, e703. doi: http://dx.doi.org/10.4236/oalib.1110703.
Cassiano, A.N., Vitorino, A.B.F., de Oliveira, S.I.M., et al. (2020) Perinatal Outcomes in Pregnant Women with Hypertensive Syndromes: An Integrative Review. Revista de Enfermeria UFSM—REUFSM Santa Maria, RS, 10, e23.
Koné, J., Traoré, S.O., Touré, M.K., Doumbia, D., Camara, D., Koné, P., et al. (2018) Impact de la Pré-éclampsie sur la Morbidité et la Mortalité Néonatales Neonatal Outcome in Preeclampsia. Health Sciences and Disease, 19, 66-70.
De Moura, M.D.R., Margotto, P.R., Costa, K.N. and Garbi Novaes, M.R.C. (2021) Hypertension Induced by Pregnancy and Neonatal Outcome: Results from a Retrospective Cohort Study in Preterm under 34 Weeks. PLOS ONE, 16, e0255783.
Ouattara, A., et al. (2015) L’éclampsie au CHU-Yalgado de Ouagadougou (Burkina Faso) du 1er avril 2013 au 31 mars 2014. Bulletin de la Société de Pathologie Exotique, 108, 316-323. https://doi.org/10.1007/s13149-015-0456-z
Roudet, V. (2014) Prévalence de l’acidose respiratoire chez les nouveau-nés présentant un pH artériel inférieur à 7, 20 à la naissance par l’utilisation de la méthode d’Eisenberg et comparaison de leur pronostic.
Thakur, J., Bhatta, N.K., Singh, R.R., Poudel, P. and Lamsal, M. (2018) Prevalence of Electrolyte Disturbances in Perinatal Asphyxia: A Prospective Study. Italian Journal of Pediatrics, 44, Article No. 56. https://doi.org/10.1186/s13052-018-0496-7
License, I. (2017) Pré-éclampsie sévère avant 34 SA: Diagnostic, prise en charge et pronostic materno-foetal. état des lieux au CHRU de Brest de janvier 2011 à décembre 2014 Céline Guillemot.
Khan, B., Allah Yar, R., Khakwani, A., et al. (2022) Preeclampsia Incidence and Its Maternal and Neonatal Outcomes with Associated Risk Factors. Cureus, 14, e31143.
https://doi.org/10.7759/cureus.31143
Bromfield, S.G., Ma, Q., Devries, A., Inglis, T. and Gordon, A.S. (2023) The Association between Hypertensive Disorders during Pregnancy and Maternal and Neonatal Outcomes: A Retrospective Claims Analysis. BMC Pregnancy Childbirth, 23, Article No. 514. https://doi.org/10.1186/s12884-023-05818-9
Zupan-Simunek, V. (2010) Pronostic des nouveau-ne de mères prééclamptiques. Annales Françaises d’Anesthésie et de Réanimation, 29, e135-e139.
https://doi.org/10.1016/j.annfar.2010.03.013
Thornton, C., Dahlen, H., Korda, A. and Hennessy, A. (2013) The Incidence of Preeclampsia and Eclampsia and Associated Maternal Mortality in Australia from Population-Linked. YMOB, 208, 476.e1-476.e5.
https://doi.org/10.1016/j.ajog.2013.02.042
Tian, T., Wang, L., Ye, R., Liu, J. and Ren, A. (2020) Maternal Hypertension, Preeclampsia, and Risk of Neonatal Respiratory Disorders in a Large-Prospective Cohort Study. Pregnancy Hypertension, 19, 131-137.
https://doi.org/10.1016/j.preghy.2020.01.006
Chahid, N., Boudana, S., Kabiri, M., Mrabet, M. and Barkat, A. (2014) Retentissement fœtal et néonatal de l’hypertension artérielle gravidique: Données marocaines. Journal de Pédiatrie et de Puériculture, 27, 111-116.
https://doi.org/10.1016/j.jpp.2014.04.005
Tolu, L.B., Yigezu, E., Urgie, T. and Feyissa, G.T. (2020) Maternal and Perinatal Outcome of Preeclampsia without Severe Feature among Pregnant Women Managed at a Tertiary Referral Hospital in Urban Ethiopia. PLOS ONE, 15, e0230638.
Uwizeyimana, P., Musabyemariya, E., Tengera, O. and Collins, A. (2020) Neonatal Outcomes from Mothers with Hypertension Disorders of Pregnancy: A Retrospective Study at a Referral Hospital in Rwanda. Rwanda Journal of Medicine and Health Sciences, 3, 193-203. https://doi.org/10.4314/rjmhs.v3i2.9
Koum, D.C.K., et al. (2015) Morbidité et facteurs de risque de mortalité néonatale dans un hôpital de référence de Douala. The Pan African Medical Journal, 20, Article No. 258.
Misganaw, F.M., Marta, B.B. and Getie, L.A. (2019) Perinatal Outcomes of Severe Preeclampsia/Eclampsia and Associated Factors among Mothers Admitted in Amhara Region. BMC Research Notes, 12, Article No. 147.
https://doi.org/10.1186/s13104-019-4161-z
Kelly, R., Ramaiah, S.M., Sheridan, H., Cruickshank, H., Rudnicka, M., Kissack, C., et al. (2017) Dose-Dependent Relationship between Acidosis at Birth and Likelihood of Death or Cerebral Palsy. ADC Fetal & Neonatal Edition, 103, 567-572.
https://doi.org/10.1136/archdischild-2017-314034
Indrio, F., Marchese, F., Rinaldi, M., Maffei, G., Dargenio, V. and Cinquepalmi, R. (2022) Is Acidemia at Birth a Risk Factor for Functional Gastrointestinal Disorders? European Journal of Pediatrics, 181, 3625-3633.
https://doi.org/10.1007/s00431-022-04565-x
Cnattingius, S., Johansson, S. and Razaz, N. (2020) Rates of Metabolic Acidosis at Birth and Apgar Score Values at 1, 5, and 10 min in Term Infants: A Swedish Cohort Study. Journal of Perinatal Medicine, 48, 514-515.
https://doi.org/10.1515/jpm-2019-0429
Lyu, X., et al. (2021) Morbidity and Maternal and Infant Outcomes of Hypertensive Disorder in Pregnancy in China in 2018. The Journal of Clinical Hypertension, 23, 1194-1204. https://doi.org/10.1111/jch.14248
Boiro, D., Faye, P.M., Gueye, M., Sow, A., Dieng, A., Ndongo, A.A., et al. (2018) La pré-éclampsie: Quelles complications chez le nouveau-né? Journal de Pédiatrie et de Puériculture, 31, 282-286. https://doi.org/10.1016/j.jpp.2018.09.009
Muhe, L.M., McClure, E.M., Nigussie, A.K., Mekasha, A., Worku, B., Worku, A., et al. (2019) Major Causes of Death in Preterm Infants in Selected Hospitals in Ethiopia (SIP): A Prospective, Cross-Sectional, Observational Study. The Lancet Global Health, 7, e1130-e1138. https://doi.org/10.1016/S2214-109X(19)30220-7
Deshmukh, M. and Patole, S. (2017) Antenatal Corticosteroids for Neonates Born before 25 Weeks—A Systematic Review and Meta-Analysis. PLOS ONE, 12, e0176090.
https://doi.org/10.1371/journal.pone.0176090
Nathan, H.L., Seed, P.T., Hezelgrave, N.L., De Greeff, A., Lawley, E., Conti-Ramsden, F., et al. (2018) Maternal and Perinatal Adverse Outcomes in Women with Pre-Eclampsia Cared for at Facility-Level in South Africa: A Prospective Cohort Study. Journal of Global Health, 8, Article ID: 020401.
https://doi.org/10.7189/jogh.08.020401
Dassah, E.T., Kusi-Mensah, E., Morhe, E.S.K. and Odoi, A.T. (2019) Maternal and Perinatal Outcomes among Women with Hypertensive Disorders in Pregnancy in Kumasi, Ghana. PLOS ONE, 14, e0223478.
https://doi.org/10.1371/journal.pone.0223478
Kiondo, P., Tumwesigye, N.M., Wandabwa, J., Wamuyu-Maina, G., Bimenya, G.S. and Okong, P. (2014) Adverse Neonatal Outcomes in Women with Pre-Eclampsia in Mulago Hospital, Kampala, Uganda: A Cross-Sectional Study. The Pan African Medical Journal, 17, Article No. 7.
https://doi.org/10.11604/pamjs.supp.2014.17.1.3014
van Esch, J.J.A., van Heijst, A.F., de Haan, A.F.J. and van der Heijden, O.W.H. (2017) Early-Onset Preeclampsia Is Associated with Perinatal Mortality and Severe Neonatal Morbidity. The Journal of Maternal-Fetal & Neonatal Medicine, 30, 2789-2794. https://doi.org/10.1080/14767058.2016.1263295
Hossain, S., Roy, S., Kirk, K. and Warren, C. (2019) Hypertensive Disorders in Pregnancy: Assessing Postnatal Quality of Care and Outcomes for Women and Their Infants in Bangladesh. The Population Council, Inc., New York.
Shen, M., Smith, G.N., Rodger, M., White, R.R., Walker, C. and Wen, S.W. (2017) Comparison of Risk Factors and Outcomes of Gestational Hypertension and Pre-Eclampsia. PLOS ONE, 12, e0175914.
https://doi.org/10.1371/journal.pone.0175914
Kumari, A., Chakrawarty, A., Singh, A. and Singh, R. (2014) Maternofoetal Complications and Their Association with Proteinuria in a Tertiary Care Hospital of a Developing Country. Journal of Pregnancy, 2014, Article ID: 431837.
https://doi.org/10.1155/2014/431837
