Non-immune hydrops fetalis was rare in Sweden during 1997-2015, but cases were associated with complications and poor prognosis

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T1 - Non-immune hydrops fetalis was rare in Sweden during 1997-2015, but cases were associated with complications and poor prognosis

AU - Whybra, Catharina

AU - Källén, Karin

AU - Hansson, Stefan R.

AU - Gunnarsson, Rolf

PY - 2020

Y1 - 2020

N2 - Aim: The study was designed to document the incidence of non-immune hydrops fetalis (NIHF) at birth and characterise associated outcomes and obstetric complications. Methods: Data on more than 1.9 million births were extracted from the Swedish Birth Register for 1997-2015. Pregnancies not affected by NIHF served as controls. National registers on mortality and hospitalisations provided follow-up information. Results: There were 309 cases of NIHF at birth corresponding to an incidence of 1.6 per 10 000, lower than in previous studies. NIHF was more frequent in mothers aged ≥35 years and with a history of stillbirth. Preterm delivery occurred in 77.7% in the NIHF group, including 31.7% before 32 weeks of gestation. Multiple births and Caesarean sections were reported more frequent in the NIHF group. NIHF was associated with poor outcome with 14.6% stillbirths and in 26.5% early neonatal death. Overall, 58.7% of live-born children with NIHF were alive at 12 months compared with 99.7% of controls. The most common causes of death were cardiovascular diseases and thoracic abnormalities. Conclusion: NIHF at birth is associated with obstetric complications and poor prognosis for the neonate related to underlying disease. The low incidence of NIHF observed in this study may reflect well-developed antenatal care.

AB - Aim: The study was designed to document the incidence of non-immune hydrops fetalis (NIHF) at birth and characterise associated outcomes and obstetric complications. Methods: Data on more than 1.9 million births were extracted from the Swedish Birth Register for 1997-2015. Pregnancies not affected by NIHF served as controls. National registers on mortality and hospitalisations provided follow-up information. Results: There were 309 cases of NIHF at birth corresponding to an incidence of 1.6 per 10 000, lower than in previous studies. NIHF was more frequent in mothers aged ≥35 years and with a history of stillbirth. Preterm delivery occurred in 77.7% in the NIHF group, including 31.7% before 32 weeks of gestation. Multiple births and Caesarean sections were reported more frequent in the NIHF group. NIHF was associated with poor outcome with 14.6% stillbirths and in 26.5% early neonatal death. Overall, 58.7% of live-born children with NIHF were alive at 12 months compared with 99.7% of controls. The most common causes of death were cardiovascular diseases and thoracic abnormalities. Conclusion: NIHF at birth is associated with obstetric complications and poor prognosis for the neonate related to underlying disease. The low incidence of NIHF observed in this study may reflect well-developed antenatal care.

KW - incidence

KW - non-immune hydrops fetalis

KW - obstetric complications

KW - poor prognosis

KW - population study

U2 - 10.1111/apa.15260

DO - 10.1111/apa.15260

M3 - Article

C2 - 32187745

AN - SCOPUS:85084138491

VL - 109

SP - 2570

EP - 2577

JO - Acta Pædiatrica

JF - Acta Pædiatrica

SN - 1651-2227

IS - 12

ER -