Evaluating the association between neonatal mortality and maternal high blood pressure, heart disease and gestational diabetes: A case control study

Tannaz Valadbeigi; Ali ArabAhmadi; Naghi Dara; Saleheh Tajalli; Amirhossein Hosseini; Koorosh Etemad; Fatemeh Zolfizadeh; Negar Piri; Mohammad Afkar; Niloufar Taherpour; Aliakbar Sayyari; Farid Imanzadeh; Mahmoud Hajipour

doi:10.4103/jrms.JRMS_814_18

Evaluating the association between neonatal mortality and maternal high blood pressure, heart disease and gestational diabetes: A case control study

J Res Med Sci. 2020 Mar 18:25:23. doi: 10.4103/jrms.JRMS_814_18. eCollection 2020.

Authors

Affiliations

¹ Student Research Committee, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic republic of Iran, Iran.
² Pediatric Gastroenterology, Hepatology, and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
⁴ Department of Epidemiology, Environmental and Occupational Hazards Control Research Center, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁵ Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
⁶ Student Research Committee, Epidemiology Department, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁷ Torbat Jam Facualty of Medical Science, Torbat Jam, Iran.

Abstract

Background: Prevention of noncommunicable diseases (NCDs) during pregnancy is recommended due to severe complications for mothers and infants. Considering that NCDs have a significant impact on infant mortality, this study was conducted to investigate the relationship between mothers' underlying diseases and gestational diabetes and infant mortality in Iran.

Materials and methods: Mothers who referred to the health centers in nine provinces of Iran were included. This case-control study used data collected from pregnant women. There were 1162 cases and 1624 controls. The required data were collected from mothers' health records and through interviews.

Results: The chances of neonatal mortality in women with a body mass index (BMI) of 30-35, 1.7 times (odds ratio [OR] = 1.7, confidence interval [CI]: 1.19-2.44, P = 0.003) was higher compared with women with a normal BMI. The chance of neonatal mortality among mothers with high blood pressure was three times higher compared with healthy mothers (OR = 3.04, 95% CI: 1.98-4.65, P < 0.001). The chance of neonatal mortality in women with kidney disease was also 1.64 times higher than mothers without kidney problems (OR = 1.64, 95% CI: 1.1-2.45, P = 0.015). In the study of gestational diabetes, the chance of neonatal mortality among the mothers who had at risk was 1.63 times higher than mothers without gestational diabetes (OR = 1.63, 95% CI: 0.84-3.16, P = 0.014). Furthermore, the chance of neonatal mortality among the mothers who had heart disease was 1.10 times higher than mothers without heart disease (OR = 2.10, 95% CI: 0.88-4.99, P = 0.014).

Conclusion: This study showed that undiagnosed underlying diseases were related to neonatal mortality, which highlights the importance of caring for and counseling about the underlying diseases, screening, and controlling blood sugar levels before and during pregnancy to prevent infant mortality by all means possible.

Keywords: Gestational diabetes; high blood pressure (hypertension); kidney disease; neonatal mortality.