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Sept. 20, 2006 -- Despite a huge drop in preeclampsia stillbirths, there's been no increase in deaths among prematurely delivered preeclampsia newborns.
The finding comes from Norway, where Olga Basso, PhD, and colleagues analyzed 37 years of birth-registry data. But it reflects the worldwide success of modern medical management of preeclampsia.
Preeclampsia threatens the lives of both mothers and children. As many as one in 20 pregnant women have preeclampsia, marked by a sharp rise in blood pressure accompanied by protein in the urine.
It's a terrible dilemma. If a preeclampsia pregnancypregnancy is allowed to continue, the mother and her child may die. But there is an increased risk of death to babies delivered prematurely.
Modern medicine tends to treat preeclampsia very aggressively. If the condition does not resolve quickly, doctors induce early delivery and are apt to perform emergency C-sections -- even if the baby is very premature.
That strategy is working, Basso and colleagues find. From 1967 to 1978, a mother with preeclampsia was 4.2 times more likely to have a stillborn child than a mother without preeclampsia. That 420% increased risk dropped to only 30% between 1991 and 2003.
During the same time, there was no rise in the risk of infant death among children born to mothers with preeclampsia. That risk -- a 70% increase in infant death following a preeclampsia pregnancy -- remained stable.
"Preeclampsia still carries a twofold increased risk of neonatal death, which has changed little over time," Basso and colleagues note. "This stability in neonatal risk is remarkable, considering the increasing number of very premature preterm deliveries in recent years resulting from aggressive obstetric management of preeclampsia."
The Basso study appears in the Sept. 20 issue of The Journal of the American Medical Association.
SOURCES: Basso, O. The Journal of the American Medical Association, Sept. 20, 2006; vol 296: pp 1357-1362.