Short- and long-term outcome of infants born after maternal (pre)-eclampsia, HELLP syndrome and thrombophilia: a retrospective, cohort study.

Objectives: To investigate the short- and long-term outcome of children born from mothers with pre-eclampsia, eclampsia and/or HELLP syndrome, and to determine the differences between children born from mothers with and without underlying thrombophilic disorder.

Study Design: Four hundred and nine infants (from 370 women) born between February 1991 and January 2006 were eligible for evaluation and were classified into group A (n = 162) and group B (n = 247). Thirty-four infants were not admitted to the hospital. Between-group differences were tested with regard to neonatal mortality, morbidity and follow-up measurements for neuromotor and mental development at 9 months and 2 years of age, using two-tailed Student's t-tests, Fisher's exact tests and logistic regression models.

Results: Of the 409 infants, 44 infants (10.8%; n = 20 group A/n = 24 group B) died. The mean gestational age in both groups was 31.9 (SD: 3.5) weeks. Of the 375 admitted infants 152 (40.5%) were related to a thrombophilic mother and 223 (59.5%) were not. Six children were lost to follow-up. At 9 months and 2 years of age development was assessed in 326 surviving children. At 9 months of age, 193 (59.2%; n = 66 group A/n = 127 group B) children showed a normal (52% group A versus 63.8% group B, P=0.046), 24 (7.4%; n = 9 group A/n = 15 group B) a suspect and 14 (4.3%; n = 6 group A, n=8 group B) an abnormal development during follow-up assessment. Ninety-five children (29.1%; n = 46 group A/n = 49 group B) did not have a follow-up assessment. At 2 years of age, 112 children (34.4%; n = 43 group A/n = 69 group B) had a normal, 21 (6.4%; n = 11 group A/n = 10 group B) a suspect and 17 (5.2%; n = 5 group A/n = 12 group B) an abnormal development. 176 children (54%; n = 70 group A/n = 106 group B) did not have a follow-up assessment.

Conclusion: Short-term outcome was not different between infants from mothers with or without thrombophilic disorders. At 9 months of age, the probability of having a normal development was significantly lower in children born from a mother with an underlying thrombophilic disorder than in those without. At 2 years of age, no differences in development were observed.