Neonatal outcome of preterm infants born to mothers with placenta previa

The purpose of this retrospective study was to investigate the neonatal outcome of preterm infants born to mothers with placenta previa (PP), especially, the outcome of respiratory distress syndrome (RDS). The preterm infants born to PP mothers treated with expectant management and admitted to a tertiary care hospital between January 1989 and December 1995 were sequentially included. Obstetrical and neonatal variables, such as the timing and severity of antepartum hemorrhage, maternal hemoglobin values, fetal distress, Apgar scores, blood gas values, the incidence and severity of RDS, and neonatal mortality were analyzed. Infants with congenital anomalies, hydrops fetalis, intrauterine growth retardation, or who were born to diabetic mothers or to hypertensive mothers, or who were non-singletons were excluded. Sixty-eight infants born to mothers with PP were studied but 53 cases were finally enrolled. The mean birth weight and gestational age were 2021 ± 624 g and 32.7 ± 3.1 weeks, respectively. Almost all the mothers had antepartum hemorrhage (94%) and the majority (98%) of the infants were born cesarean section. Thirty-one infants (58%) had RDS. The PaO₂/FiO₂ ratio of the infants with RDS was 1.83 ± 0.86 and their a/A ratio was 0.32 ± O.17. The neonatal mortality was 9.4% with the main cause of death being RDS. Fetal distress, low Apgar scores, and metabolic acidosis at birth significantly contributed to the development of RDS when these infants were compared with the non-RDS preterm infants.