VP36.07: A retrospective cohort study on the clinical approach to neonatal adverse respiratory outcome prevention in late preterm SGA singletons

Introduction: Late preterm infants (LPIs) are infants born between 340/7 and 366/7 weeks gestation. Morbidities in these infants are commonly considered a result of prematurity; however, some research has suggested immaturity may not be the sole cause of morbidities. We hypothesize that antecedents leading to late preterm birth are associated with different patterns of morbidities and that morbidities are the result of gestational age superimposed by the underlying etiologies of preterm delivery. Methods: This is a retrospective cohort study of late preterm neonates born at a single tertiary care center. We examined neonatal morbidities including apnea of prematurity, hyperbilirubinemia, hypoglycemia, and the requirement for continuous positive airway pressure (CPAP). Multivariable logistic regression analysis was performed to estimate the risk of each morbidity associated with 3 categorized antecedents of delivery, that is, spontaneous preterm labor, preterm premature rupture of membranes (PPROM), and medically indicated birth. We calculated the predictive probability of each antecedent resulting in individual morbidity across gestational ages. Results: 279 LPIs were included in the study. Decreasing gestational age was associated with significantly increased risk of apnea of prematurity, hyperbilirubinemia, and requirement of CPAP. In our cohort, the risk of hypoglycemia increased with gestational age, with the greatest incidence at 360−6 weeks. There was no significant association of risk of selected morbidities and the antecedents of late preterm delivery, with or without adjustment for gestational age, multiple gestation, small for gestational age (SGA), antenatal steroids, and delivery method. Discussion and Conclusion: This study found no difference in morbidity risk related to 3 common antecedents of preterm birth in LPIs. Our research suggests that immaturity is the primary factor in determining adverse outcomes, intensified by factors resulting in prematurity.

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Emotional and behavioral outcomes and quality of life in school-age children born as late preterm: retrospective cohort study

Croatian Medical Journal ◽

10.3325/cmj.2017.58.332 ◽

2017 ◽

Vol 58 (5) ◽

pp. 332-341 ◽

Cited By ~ 2

Author(s):

Branka Polić ◽

Andreja Bubić ◽

Julije Meštrović ◽

Joško Markić ◽

Tanja Kovačević ◽

...

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Behavioral Outcomes ◽

Late Preterm ◽

School Age Children ◽

School Age

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Biological determinants of spontaneous late preterm and early term birth: a retrospective cohort study

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.13191 ◽

2014 ◽

Vol 122 (4) ◽

pp. 491-499 ◽

Cited By ~ 21

Author(s):

HK Brown ◽

KN Speechley ◽

J Macnab ◽

R Natale ◽

MK Campbell

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Late Preterm ◽

Term Birth ◽

Early Term ◽

Biological Determinants

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Late preterm birth is a strong predictor of maternal stress later in life: Retrospective cohort study in school-aged children

Journal of Paediatrics and Child Health ◽

10.1111/jpc.13167 ◽

2016 ◽

Vol 52 (6) ◽

pp. 608-613 ◽

Cited By ~ 5

Author(s):

Branka Polic ◽

Andreja Bubic ◽

Julije Mestrovic ◽

Josko Markic ◽

Tanja Kovacevic ◽

...

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Maternal Stress ◽

Strong Predictor ◽

Late Preterm ◽

School Aged Children ◽

Late Preterm Birth

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Maternal High Triglyceride Levels During Early Pregnancy and Risk of Preterm Delivery: A Retrospective Cohort Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-01372 ◽

2018 ◽

Vol 104 (4) ◽

pp. 1249-1258 ◽

Cited By ~ 4

Author(s):

Xian-hua Lin ◽

Dan-dan Wu ◽

Cheng Li ◽

Yi-jing Xu ◽

Ling Gao ◽

...

Keyword(s):

Cohort Study ◽

Preterm Delivery ◽

Early Pregnancy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Maternal Obesity ◽

Late Preterm ◽

Sensitivity Analyses ◽

Singleton Pregnancy ◽

Related Risk

Abstract Context Maternal obesity increases the risk of preterm delivery. Obesity is known to be associated with altered lipid metabolism. Objective To investigate the associations between high maternal triglyceride (mTG) levels during early pregnancy and risks of preterm delivery stratified by early pregnancy body mass index (BMI). Design Retrospective cohort study. Setting University-based maternity center. Patients 49,612 women with singleton pregnancy who underwent fasting serum lipid screening during early pregnancy. Main Outcome Measures Risk of preterm delivery (total, <37 weeks; early, 28 to 33 weeks; and late, 34 to 36 weeks). Results Among women enrolled, 2494 had a preterm delivery, including 438 early preterm and 2056 late preterm delivery. High mTG (>90th percentile, 2.04 mM) was associated with shortened gestation. Risks of total, early, and late preterm deliveries increased with mTG levels, and the high mTG–related risk was highest for early preterm delivery [adjusted odds ratio (AOR) 1.72; 95% CI, 1.30 to 2.29]. After stratification by BMI, high mTG was associated with risk of preterm delivery in both overweight or obese (OWO) women (AOR 1.32; 95% CI, 1.02 to 1.70) and women with normal BMI (AOR 1.36; 95% CI, 1.16 to 1.59). In additional sensitivity analyses, we found that high mTG was related to higher risks of preterm delivery among OWO women and women with normal BMI (AOR, 1.54; 95% CI, 1.07 to 2.22 and 1.62, 1.34 to 1.96, respectively), especially early preterm delivery (AOR 2.47; 95% CI, 1.19 to 5.10, and AOR 2.50; 95% CI, 1.65 to 3.78, respectively). Conclusions High mTG level during early pregnancy increased the risks of preterm delivery not only in OWO women but also in women with normal BMI.

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