Long-Term Consequences of Severe Maternal Morbidity on Infant Growth and Development
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Long‑Term Consequences of Severe Maternal Morbidity on Infant Growth and Development Dulce M. Zanardi1 · Juliana P. Santos1 · Rodolfo C. Pacagnella1 · Mary A. Parpinelli1 · Carla Silveira1 · Carla B. Andreucci1,2 · Elton C. Ferreira1 · Carina R. Angelini1 · Renato T. Souza1 · Maria L. Costa1 · Jose G. Cecatti1 Accepted: 7 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objective Severe maternal morbidity (SMM) is already known to be associated with adverse neonatal outcomes, however, its association with long-term deficits of weight and height, and impairment in neurodevelopment among children was not yet fully assessed. We aim to evaluate whether SMM has repercussions on the weight and height-for-age and neurodevelopmental status of the child. Methods A retrospective cohort analysis with women who had SMM events in a tertiary referral center in Brazil. They were compared to a control group of women who had not experienced any SMM. Childbirth and perinatal characteristics, weight and height-for-age deficits and neurodevelopmental impairment suspicion by Denver II Test were comparatively assessed in both groups using RR and 95% CI. Multiple regression analysis was used addressing deficit of weight-for-age, height-for-age and an altered Denver Test, estimating their independent adjusted RR and 95% CI. Results 634 women with perinatal outcomes available (311 with SMM and 323 without) and 571 children were assessed. Among women with SMM, increased rates in perinatal deaths, Apgar lower than 7 at five minutes, shorter breastfeeding period, preterm birth (49.0% × 11.1%), low birthweight (45.8% × 11.5%), deficits of weight-for-age [RR 3.11 (1.60–6.04)] and height-for-age [RR 1.52 (1.06–2.19)] and altered Denver Test [RR 1.5 (1.02–2.36)] were more frequently found than in the control group. SMM was not identified as independently associated with any of the main outcomes. Conclusion SMM showed to be associated with a negative impact on growth and neurodevelopment aspects of perinatal and infant health. These findings suggest that effective health policies directed towards appropriate care of pregnancy may have an impact on the reduction of maternal, neonatal and infant morbidity and mortality. Keywords Severe maternal morbidity · Complications of pregnancy · Child growth · Child development Abbreviations CATI Computer-assisted telephone interview MNM Maternal near miss SMM Severe maternal morbidity WHO World Health Organization WHODAS WHO Disability Assessment Schedule Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10995-020-03070-7) contains supplementary material, which is available to authorized users. * Jose G. Cecatti [email protected] 1
Department of Obstetrics and Gynecology, School of Medical Sciences, CAISM, University of Campinas, Campinas, Brazil
Department of Medicine, School of Medicine, Federal University of Sao Carlos, São Carlos, Brazil
2
Significance Statement The occurrence of Severe Mater
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