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Neonatal-Perinatal Health Care Delivery: Epidemiology/Health Services Research

Neonatal-Perinatal Health Care Delivery 3: Epi/HSR Antenatal Exposures and Neonatal Outcomes

753 - Association Between Maternal Abortion History and Neonatal Outcome among Very Preterm Infants：a multicenter cohort study

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 753
Publication Number: 753.246

Min Yang, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Jiale Dai, Obstetrics and Gynecology Hospital of Fudan University, shanghai, Shanghai, China (People's Republic); Xiaobo Fan, Obstetrics and Gynecology Hospital of Fudan University, shanghai, Shanghai, China (People's Republic); Yun Cao, Children's Hospital of Fudan University, Shanghai, PCR, Shanghai, Shanghai, China (People's Republic); Wenhao Zhou, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Shoo K. Lee, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada; Jimei Wang, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Liyuan Hu, Fudan University, shanghai, Shanghai, China (People's Republic)

Presenting Author(s)

Min Yang, MD

associate chief physician
Obstetrics and Gynecology Hospital of Fudan University
Shanghai, Shanghai, China (People's Republic)

Background:

It is unclear whether there is an association between maternal abortion history and neonatal outcomes of singleton very preterm infants (VPIs).

Objective: To determine whether maternal abortion history is associated with neonatal outcome of VPIs in China.

Design/Methods: All first parity VPIs born at < 32 weeks gestational age (GA) who were admitted to neonatal intensive care units (NICU) participating in the Chinese Neonatal Network (CHNN) from 2019 to 2021 were included in the study. Multivariable logistic regression models were constructed to compare neonatal outcomes among infants with different maternal abortion histories after controlling for confounders.

Results:

A total of 7256 VPIs were included in this analysis. Overall, 3133 (43.18%) infants had positive maternal abortion history (Table 1). The incidence of mortality or any major morbidity (P< 0.01), respiratory distress syndrome (RDS) (P< 0.01), patent ductus arteriosus (PDA) (P=0.01), intraventricular haemorrhage (IVH) (P< 0.01), IVH stage 3 or 4 (P=0.04), moderate or severe bronchopulmonary dysplasia (BPD) (P< 0.01), retinopathy of prematurity (ROP) (P< 0.01), ROP stage 3, 4, or 5 (P=0.03) tended to increase significantly with increasing number of maternal abortion histories among non-abortion group, 1 abortion and ³2 abortions group (Table 2). Multivariable analysis showed that maternal abortion history was significantly associated with higher risks of mortality or any major morbidity (adjusted odds ratio [aOR] 1.15, 95% confidence interval [CI] 1.03-1.29), RDS (aOR 1.22, 95%CI 1.08-1.38), IVH (aOR 1.17, 95% CI 1.05-1.31), and IVH stage 3 or 4 (aOR 1.27, 95% CI 1.01-1.59). Risk increased with the number of abortions. VPIs of mothers with two or more abortions had the highest risk of mortality or any major morbidity (aOR 1.18, 95% CI 1.02-1.36), RDS (aOR 1.35, 95% CI 1.18-1.56), IVH (aOR 1.23, 95% CI 1.07-1.43) and moderate or severe BPD (aOR 1.17, 95% CI 1.01-1.36), compared to the non-abortion group (Table 3).

Conclusion(s):

VPIs born to mothers with previous abortion history have greater risk of adverse outcomes, of which the mechanism requires further investigations.