Neonatal outcomes as per gestational age in late preterm births: a retrospective study

Ankur Gupta; Soujanya B. S.; Kamath K. Madhava

doi:10.18203/2349-3291.ijcp20164031

Authors

Ankur Gupta Department of Pediatrics, K. S. Hegde Medical Academy, Nitte University, Mangalore, Karnataka, India
Soujanya B. S. Department of Pediatrics, K. S. Hegde Medical Academy, Nitte University, Mangalore, Karnataka, India
Kamath K. Madhava Department of Pediatrics, Adichunchungiri Institute of Medical Sciences, Mandya District, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20164031

Keywords:

Hypoglycemia, Late preterm, Neonatal jaundice, RDS, Sepsis

Abstract

Background: Late preterm infants (34 week to 36 week + 6 days of gestation) are physiologically immature and have limited compensatory responses to the extra-uterine environment. Aim of the study was to compare the incidence of neonatal complications of late preterm infants compared to those born at term gestation and admitted in neonatal intensive care unit in a tertiary care hospital in south India.

Methods: We retrospectively analyzed late preterm deliveries reported in 24 months period. Late preterm were divided in 3 sub-groups according to gestational age at delivery: 34 week + 6 days, 35 week + 6 days, 36 week + 6 days of gestation. The incidence of major clinical complications was evaluated. Statistical analysis was performed by using the Z- test. All babies admitted from March 2014 to February 2016 were retrospectively studied.

Results: Among late preterm deliveries 53% were admitted to the neonatal intensive care unit. Out of which 35% presented with neonatal jaundice, 27% Respiratory distress syndrome (RDS), and sepsis 18 % .The incidence of RDS, jaundice and sepsis was significantly higher at 34 0/6 and 35 0/6 weeks of gestation, compared to full-term infants. Finally, the incidence of jaundice and RDS results significantly higher in all the 3 subgroups of late preterm, in contrast to full term infants.

Conclusions: Results demonstrated an increased risk of morbidity in the late preterm period in contrast with term infants. Results also displayed that the gestational age at delivery of late preterm can influence the risk of adverse neonatal outcomes.

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References

Gotsch F, Gotsch F, Romero R, Erez O, Vaisbuch E, Kusanovic JP, et al. The preterm parturition syndrome and its implications for understanding the biology, risk assessment, diagnosis, treatment and prevention of preterm birth. J Matern Fetal Neonatal Med. 2009;22(Suppl 2):5-23.

Committee on obstetric practice ACOG committee opinion late-preterm infants. Obstet Gynecol. 2008;111:1029-32.

Wang ML, Dorer DJ, Fleming MP, Catlin EA. Clinical outcomes of near-term infants. Pediatrics. 2004;114:372-6.

Khashu M, Narayanan M, Bhargava S, Osiovich H. Perinatal outcomes associated with preterm birth at 33 to 36 weeks’ gestation: a population-based cohort study. Pediatrics. 2009;123:109-13.

McIntire DD, Leveno KJ. Neonatal mortality and morbidity rates in late preterm births compared with births at term. Obstet Gynecol. 2008;111:35-41.

Young PC, Glasgow TS, Xi Li, Guest-Warnick G, Stoddard GJ. Mortality of late-preterm (near-term) newborns in Utah. Pediatrics. 2007;119:659-65.

Abe K, Shapiro-Mendoza CK, Hall LR, Satten GA. Late preterm birth and risk of developing asthma. J Pediatr. 2010;157:74-8.

Consortium on Safe Labor, Hibbard JU, Wilkins I, Sun L, Gregory K, Haberman S, et al. Respiratory morbidity in late preterm births. JAMA. 2010;304(4):419-25.

Melamed N, Klinger G, Tenenbaum-Gavish K, Herscovici T, Linder N, Hod M, et al. Short term neonatal outcome in low risk, spontaneous, singleton, late preterm deliveries. Obstet Gynecol. 2009;114:253-60.

Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, Barfield W, Weiss J, Nannini A, et al. Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk. Pediatrics. 2008;121:223-32.