Paediatrics: Maternal disorders causing neonatal disease
Any maternal disease can adversely affect foetal and neonatal health.
Maternal disorders causing neonatal disease
Any maternal disease can adversely affect foetal and neonatal health. Certain maternal illnesses, e.g. CHD, also raise the risk of inheritance in the newborn. Most common manifestations are:
- Spontaneous abortion.
- Foetal death.
- IUGR and/or preterm delivery.
Maternal drug ingestion
Maternal medications or substance abuse can affect the newborn:
- maternal anticonvulsants;
- alcohol abuse and foetal alcohol syndrome;
- neonatal abstinence syndrome.
Pregnancy-induced hypertension (e.g. pre-eclampsia, eclampsia, haemolytic anaemia–elevated liver enzymes–low platelet count (HELLP) syndrome) is associated with increased foetal loss, the need for preterm delivery, IUGR, neonatal leucopenia, and thrombocytopenia. Maternal drug treatment may cause neonatal hypoglycaemia and hypotension.
Systemic lupus erythematosus
- Rise - Risk of spontaneous abortion.
- Preterm delivery.
- Neonatal lupus syndrome (rare; associated with anti-Ro and –La antibodies): complete heart block, haemolytic anaemia, leucopenia, thrombocytopenia, and discoid erythematous skin rash.
Maternal antiphospholipid antibodies (e.g. lupus anticoagulant or anticardiolipin antibodies) are associated with spontaneous abortion, IUGR, foetal death, need for preterm delivery.
In 710% of women with Graves’s disease, thyroid-stimulating hormone (TSH) receptor-stimulator antibodies cross the placenta causing neonatal thyrotoxicosis. Foetus most likely to be affected if high maternal IgG se-rum level develops, or the mother requires treatment during pregnancy. Take cord blood for TSH, fT4, and TSH receptor antibody (TRAB). Repeat at D5 if results abnormal.
In 710% transplacental passage of IgG antibodies to motor end-plate ace-tylcholine receptors causes transient neonatal myasthenia gravis.