275: Factors associated with NICU admission at term following threatened late preterm birth

AbstractObjective:To investigate the neonatal outcomes of twin pregnancies delivered at late-preterm versus term gestation based on chorionicity and indication for delivery.Study Design:This is a retrospective cohort study of women with twin pregnancies delivered at ≥34 weeks of gestation from 1995 to 2014. Subjects were categorized into two groups according to gestational age at delivery: late-preterm group (34–36 weeks) and term group (≥37 weeks). Neonatal outcome measures including neonatal intensive care unit (NICU) admission, mechanical ventilator support, and respiratory distress syndrome (RDS) were compared between the late-preterm and term group based on chorionicity (monochorionic or dichorionic) and delivery indication (elective or non-elective).Results:A total of 1198 twin pregnancies were included in the study: 679 in the late-preterm group and 519 in the term group. Late-preterm twin infants had higher rates of NICU admission, mechanical ventilator support, and RDS than did term twin infants, regardless of the chorionicity and indication for delivery. In the multivariable analysis, late-preterm birth, monochorionicity, and non-elective delivery were independently associated with a significantly higher risk of NICU admission and mechanical ventilator support.Conclusion:The late-preterm birth was associated with a higher risk of adverse neonatal outcome regardless of chorionicity and indication for delivery, and showed significantly increased risk by monochorionicity and non-elective delivery.

Download Full-text

Late preterm birth in the far south of Brazil: a population based study

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042016000200003 ◽

2016 ◽

Vol 16 (2) ◽

pp. 113-120 ◽

Cited By ~ 1

Author(s):

Adriana Kramer Fiala Machado ◽

Luana Patrícia Marmitt ◽

Juraci Almeida Cesar

Keyword(s):

Preterm Birth ◽

Skin Color ◽

Causal Relation ◽

Population Based ◽

Late Preterm ◽

Population Based Study ◽

Factors Associated ◽

Late Preterm Birth ◽

Effect Measure ◽

South Of Brazil

Abstract Objectives: to describe the prevalence of late preterm birth (LPB) and identify factors associated with its occurrence in the municipality of Rio Grande, RS. Methods: a standardized questionnaire was applied to allpuerperal women resident in the municipality who had children in theyear 2013. Preterm birth was defined as birth occur-ring between the 34th and 36th week of gestation, preferably evaluated by means of ultra-sonography in the 6th to 20th weeks. The analysis used Poisson regression with robust adjustment of variance, following the hierarchical model.The effect measure used was the preva-lence ratio (PR). Results: of the 2286 births included in the study, 11.8% (CI95%: 10.5-13.1) were LPBs. After adjusted analysis, the PRfor occurrence of LPB among black-skinned motherswas 1.40 (1.01-1.96) in relation to white-skinned women; 1.74 (1.23-2.45) among those who attended less than sixprenatal consults compared to those who attended nine or more; the PR was 1.36 (1.11-1.68) for those classified as depressives compared to others and 1.29 (1.01-1.65) for those undergoing caesarian. Conclusions: the results suggest the existence of inequality in relation to skin color and the important impact of the number ofprenatal consults on the outcome. More appropriately designed studies are needed to confirm the causal relation among maternal depression, caesarian and LPB.

Download Full-text

Factors Associated with Preterm, Early Preterm and Late Preterm Birth in Malawi

PLoS ONE ◽

10.1371/journal.pone.0090128 ◽

2014 ◽

Vol 9 (3) ◽

pp. e90128 ◽

Cited By ~ 28

Author(s):

Nynke R. van den Broek ◽

Rachel Jean-Baptiste ◽

James P. Neilson

Keyword(s):

Preterm Birth ◽

Late Preterm ◽

Factors Associated ◽

Late Preterm Birth

Download Full-text

Risk factors associated with prolonged neonatal intensive care unit stay after threatened late preterm birth

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2019.1623777 ◽

2019 ◽

pp. 1-6

Author(s):

Ashley N. Battarbee ◽

Angelica V. Glover ◽

Catherine J. Vladutiu ◽

Cynthia Gyamfi-Bannerman ◽

Sofia Aliaga ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Preterm Birth ◽

Neonatal Intensive Care Unit ◽

Intensive Care Unit Stay ◽

Neonatal Intensive Care ◽

Late Preterm ◽

Factors Associated ◽

Late Preterm Birth

Download Full-text

Morbidity in Late Preterm Birth: A Retrospective Cohort Study Assessing the Role of Immaturity versus Antecedent Factors

Neonatology ◽

10.1159/000515089 ◽

2021 ◽

pp. 1-8

Author(s):

Melissa Lorenzo ◽

Megan Laupacis ◽

Wilma M. Hopman ◽

Imtiaz Ahmad ◽

Faiza Khurshid

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Preterm Delivery ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Late Preterm ◽

Multiple Gestation ◽

Late Preterm Birth ◽

Apnea Of Prematurity

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.

Download Full-text