早产儿子痫前期宫内暴露于母体肝素介导的体外ldl -沉淀(HELP)-分离后新生儿队列的长期随访

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2025-06-23 DOI:10.1016/j.preghy.2025.101234

Martin Kuntz , Cornelia Lorey , Christine Contini , Karl Winkler , Hans Fuchs , Filiz Markfeld-Erol , Mirjam Kunze

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引用次数: 0

摘要

目的：早产先兆子痫是母亲和胎儿/新生儿发病率的重要因素，经常导致早产。Freiburg子痫前期HELP（肝素介导的体外LDL-precipitation）-Apheresis研究是一项实验性研究，旨在研究HELP -Apheresis对重度子痫前期临床和实验室结果的影响。研究结果是有希望的，表明这种方法可能有利于延长妊娠。然而，对儿童的长期影响尚未确定。研究设计和主要结果测量来自Freiburg子痫前期HELP-Apheresis研究的12名儿童（干预组6名，对照组6名）的长期结果在校正年龄24个月时使用Bayley量表进行评估，在大约10岁时使用父母问卷（CBCL4-18）进行评估。结果母亲帮助分离儿童在10岁时在贝利量表、学校技能和社交技能以及身体发育方面均表现出良好的结果。在干预组和对照组之间没有观察到显著差异。该结果与研究极低出生体重婴儿长期结果的大型队列一致。结论对重度先兆子痫母亲所生的极早产儿，产前接触HELP-apheresis对其长期预后无负面影响。然而，由于延长妊娠期，干预的潜在有益影响太小而无法识别。本研究的结果证明进一步研究脂质分离作为严重的，非常早产的先兆子痫的可能治疗选择。

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Long-term follow-up of a neonatal cohort after intrauterine exposure to maternal heparin-mediated extracorporal LDL-precipitation (HELP)-apheresis in very preterm preeclampsia

Objectives

Preterm preeclampsia represents a significant contributor to maternal and fetal/neonatal morbidity and frequently results in preterm delivery. The Freiburg preeclampsia HELP (heparin-mediated extracorporal LDL-precipitation)-Apheresis study was a pilot study designed to investigate the effects of HELP-apheresis on the clinical and laboratory outcome of severe preeclampsia. Results of the study were promising, indicating that this approach may be beneficial in prolonging pregnancy. Nevertheless, the long-term effects on the children were not determined yet.

Study design and main outcome measures

Long-term outcomes of the 12 children from the Freiburg preeclampsia HELP-Apheresis study (6 from the intervention group, 6 from the control cohort) were assessed using Bayley Scales at 24 months corrected age and a parent questionnaire (CBCL4-18) at approximately 10 years of age.

Results

Children exposed to maternal HELP-apheresis demonstrated a generally favorable outcome in terms of Bayley Scales, school and social skills, as well as body growth at 10 years of age. No significant difference between the intervention and the control cohort was observed. The results were consistent with larger cohorts studying the long-term outcomes of very low birth weight infants.

Conclusions

Prenatal exposure to maternal HELP-apheresis did not have any negative effect on the long-term outcome of very preterm infants born to mothers with severe preeclampsia. However, a potential beneficial impact of the intervention due to the prolongation of pregnancy would have been too small to be discernible. The results of this study justify further investigation of lipid-apheresis as a possible treatment option in severe, very preterm preeclampsia.

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来源期刊

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health OBSTETRICS & GYNECOLOGYPERIPHERAL VASCULAR-PERIPHERAL VASCULAR DISEASE

CiteScore

4.90

自引率

0.00%

发文量

127

期刊介绍： Pregnancy Hypertension: An International Journal of Women''s Cardiovascular Health aims to stimulate research in the field of hypertension in pregnancy, disseminate the useful results of such research, and advance education in the field. We publish articles pertaining to human and animal blood pressure during gestation, hypertension during gestation including physiology of circulatory control, pathophysiology, methodology, therapy or any other material relevant to the relationship between elevated blood pressure and pregnancy. The subtitle reflects the wider aspects of studying hypertension in pregnancy thus we also publish articles on in utero programming, nutrition, long term effects of hypertension in pregnancy on cardiovascular health and other research that helps our understanding of the etiology or consequences of hypertension in pregnancy. Case reports are not published unless of exceptional/outstanding importance to the field.