Maternal haemolysis, elevated liver enzymes and low platelets syndrome: perinatal and neurodevelopmental neonatal outcomes for infants weighing less than 1250 g

Abstract

Objectives: To study mortality and short-term morbidity of infants born to women with HELLP (haemolysis, elevated liver enzymes, and low platelets) syndrome and to compare the long-term neurodevelopmental morbidity of a subgroup with birth weight (BWT) less than 1250 g (study group) with weight matched controls.

Methods: Retrospective chart review and prospective neurodevelopmental follow-up through a Perinatal Follow-up clinic. Analysis of perinatal and neonatal data for women diagnosed with HELLP from 1993 to 1996. Neurodevelopmental outcome for the study group was compared to a group of weight matched controls.

Results: A total of 109 infants (mean gestational age 32.6 weeks, mean BWT 1766 g) were born to 104 women with HELLP syndrome. There was a significant decrease in mortality (P = 0.002) and morbidity (P < 0.05) with increasing gestational age and birthweight. No significant differences in neonatal mortality and morbidity were present between the infants weighing less than 1250 g study and weight matched control group. However, at 3 years, the study group had fewer children with cerebral palsy (P = 0.024) and mental disability (P trend = 0.07). Mean cognitive index was 99 versus 91 in the controls (P = 0.101).

Conclusion: Improved health outcomes occur with increased gestational age. Infants with BWT less than 1250 g born to women with HELLP syndrome were not at risk of increased neurodevelopmental disability compared to controls.