Neonatal morbidity and mortality by mode of delivery in very preterm neonates

Introduction: Late preterm birth (defined as birth between 34 and 36 complete weeks’ gestation) and early term birth (defined as birth between 37 and 38 complete weeks’ gestation) have become a topic of recent discussion as the morbidity associated with delivery at these gestational ages has become increasingly evident. Our objective was to evaluate the characteristics of late preterm and early term birth in Portugal. Material and Methods: We developed a survey questionnaire that was sent to the Obstetric Department of all public hospitals in Portugal. The questionnaire consisted on questions on prevalence and mode of delivery of late preterm and early term period and associated neonatal morbidity and mortality. The questions referred solely to single births occurred during 2013. Results: We received completed questionnaires from 14 hospitals, corresponding to nearly one third (33.5%) of total deliveries in Portugal. We report 5.4% of late preterm and 27% of early term deliveries. Approximately two thirds of late preterm and three quarters of early term deliveries were spontaneous. The cesarean section rate was higher in late preterm (39.1%) than in early term (26.4%) births. Neonatal complications were more frequent in late preterm neonates (34.2%) when compared to early term neonates (14.2%). Discussion: The prevalence of late preterm and early term birth in our cohort is comparable, although slightly reduced, to other published series. Conclusion: The obstetric community should raise efforts to limit deliveries below 39 weeks’ gestation to the ones with a valid medical indication.

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Association between Policy Changes for Oxygen Saturation Alarm Settings and Neonatal Morbidity and Mortality in Infants Born Very Preterm

The Journal of Pediatrics ◽

10.1016/j.jpeds.2019.01.048 ◽

2019 ◽

Vol 209 ◽

pp. 17-22.e2 ◽

Cited By ~ 1

Author(s):

Elizabeth E. Foglia ◽

Benjamin Carper ◽

Marie Gantz ◽

Sara B. DeMauro ◽

Satyan Lakshminrusimha ◽

...

Keyword(s):

Oxygen Saturation ◽

Neonatal Morbidity ◽

Morbidity And Mortality ◽

Policy Changes ◽

Very Preterm

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Survival Without Severe Neonatal Morbidity in Very Preterm Twins According to Planned Mode of Delivery

Obstetrics and Gynecology ◽

10.1097/aog.0000000000004639 ◽

2022 ◽

Vol Publish Ahead of Print ◽

Author(s):

Diane Korb ◽

François Goffinet ◽

Loïc Sentilhes ◽

Gilles Kayem ◽

Marie Victoire Sénat ◽

...

Keyword(s):

Mode Of Delivery ◽

Neonatal Morbidity ◽

Very Preterm

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The risks of advancing parental age on neonatal morbidity and mortality are U- or J-shaped for both maternal and paternal ages

BMC Pediatrics ◽

10.1186/s12887-020-02341-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

James A. Thompson

Keyword(s):

United States ◽

Maternal Age ◽

Neonatal Intensive Care ◽

Neonatal Morbidity ◽

The United States ◽

Paternal Age ◽

Morbidity And Mortality ◽

Hospital Death ◽

Very Preterm ◽

Prolonged Ventilation

Abstract Background The biologic implications of delayed parenthood have been blamed for a major public health crisis in the United States, that includes high rates of neonatal morbidity and mortality (NMM). The objective of this study was to evaluate the risk of parent age on NMM and to provide results that can serve as a starting point for more specific mediation modeling. Methods Data containing approximately 15,000,000 birth records were obtained from the United States Natality database for the years 2014 to 2018. A Bayesian modeling approach was used to estimate the both the total effect and the risk adjusted for confounding between parent ages and for mediation by chromosomal disorders including Down syndrome. Outcomes included intra-hospital death and nine measures of neonatal morbidity. Results For paternal age, seven NMM (preterm birth, very preterm birth, low Apgar score, treatment with antibiotics, treatment with surfactant, prolonged ventilation, intra-hospital death) had U-shaped risk patterns, two NMM (small for gestational age, admission to neonatal intensive care) had J-shaped risk patterns, one NMM (seizures) was not significantly related to paternal age. For maternal age, three NMM (low Apgar score, treatment with antibiotics and intra-hospital death) had U-shaped risk patterns, four NMM (preterm delivery, very preterm delivery, admission to neonatal intensive care, treatment with surfactant) had J-shaped risk patterns, one NMM (small for gestational age) had a risk declining with age, one NMM (prolonged ventilation) had a risk increasing with age and one NMM (seizures) was not significantly related to maternal age. Conclusions Both advancing maternal and paternal ages had U- or J-shaped risk patterns for neonatal morbidity and mortality.

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16 Survival without severe neonatal morbidity in very preterm twins according to planned mode of delivery

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2020.12.028 ◽

2021 ◽

Vol 224 (2) ◽

pp. S10-S11

Author(s):

Diane Korb ◽

Francois goffinet ◽

Loïc Sentilhes ◽

Gilles Kayem ◽

Marie-Victoire senat ◽

...

Keyword(s):

Mode Of Delivery ◽

Neonatal Morbidity ◽

Very Preterm

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The Effect of Birth Order on Neonatal Morbidity and Mortality in Very Preterm Twins

American Journal of Perinatology ◽

10.1055/s-0037-1598255 ◽

2017 ◽

Vol 34 (09) ◽

pp. 845-850 ◽

Cited By ~ 4

Author(s):

Elad Mei-Dan ◽

Jyotsna Shah ◽

Shoo Lee ◽

Prakesh Shah ◽

Kellie Murphy ◽

...

Keyword(s):

Birth Order ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Multivariable Analysis ◽

Neonatal Morbidity ◽

Morbidity And Mortality ◽

Matched Pair ◽

Very Preterm ◽

Matched Pair Analysis ◽

Grade 3

Objective This retrospective cohort study examined the effect of birth order on neonatal morbidity and mortality in very preterm twins. Study Design Using 2005 to 2012 data from the Canadian Neonatal Network, very preterm twins born between 24 0/7 and 32 6/7 weeks of gestation were included. Odds of morbidity and mortality of second-born cotwins compared with first-born cotwins were examined by matched-pair analysis. Outcomes were neonatal death, severe brain injury (intraventricular hemorrhage grade 3 or 4 or persistent periventricular echogenicity), bronchopulmonary dysplasia, severe retinopathy of prematurity (ROP) (> stage 2), necrotizing enterocolitis (≥ stage 2), and respiratory distress syndrome (RDS). Multivariable analysis was performed adjusting for confounders. Result There were 6,636 twins (3,318 pairs) included with a mean gestational age (GA) of 28.9 weeks. A higher rate of small for GA occurred in second-born twins (10 vs. 6%). Mortality was significantly lower for second-born twins (4.3 vs. 5.3%; adjusted odds ratio: 0.75; 95% confidence interval [CI]: 0.59–0.95). RDS (66 vs. 60%; adjusted odds ratio: 1.40; 95% CI: 1.29–1.52) and severe retinopathy (9 vs. 7%; adjusted odds ratio: 1.46; 95% CI: 1.07–2.01) were significantly higher in second-born twins. Conclusion Thus, while second-born twins had reduced odds of mortality, they also had increased odds of RDS and ROP.

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Early Neonatal Morbidity after Term Delivery: How should We respond?

Donald School Journal of Ultrasound in Obstetrics & Gynecology ◽

10.5005/jp-journals-10009-1465 ◽

2016 ◽

Vol 10 (2) ◽

pp. 180-184

Author(s):

Milan Stanojevic ◽

Lana Leko

Keyword(s):

Gestational Age ◽

Medical Records ◽

Mode Of Delivery ◽

Newborn Infants ◽

Neonatal Morbidity ◽

Morbidity And Mortality ◽

Term Infants ◽

Neonatal Deaths ◽

Term Delivery ◽

Respiratory Pathology

ABSTRACT Aim The aim of this retrospective study was to investigate the influence of gestational age and mode of delivery at term on early neonatal morbidity and mortality in a tertiary maternity center in a 10-year period. Materials and methods The data were derived from the medical records between January 1, 2005, and December 31, 2014, from the University Hospital “Sveti Duh,” Zagreb, Croatia. There were 30,363 live born term infants included in the study. The data from the medical records have been used to analyze their mode of delivery, morbidity, and mortality. Results Term newborn infants delivered by cesarean section (CS) had increased prevalence of lower Apgar scores, resuscitation, neonatal convulsions, and neonatal encephalopathy, respiratory pathology (except for amniotic fluid aspiration), and mechanical ventilation. Early and late neonatal deaths were more prevalent in term infants delivered by CS. The prevalence of birth trauma (except for facial nerve palsy) and hyperbilirubinemia was significantly increased in vaginally born neonates. The prevalence of perinatal infections was equal in both groups of infants. Morbidity and mortality of term newborn infants presented as prevalence per 1,000 live born, regardless of the mode of a delivery week by week from 37 through 41 weeks of gestation, were also investigated. The highest prevalence for most of the observed parameters were at 37 to 41 weeks of gestation, while the lowest prevalence was observed at a gestational age between 39 and 40 weeks. This was not the case for the 1st and the 5th minute 4 to 7 Apgar scores, birth injuries, respiratory pathology, and late neonatal deaths. Conclusion Early-term delivery was connected with more morbidity and mortality in the early neonatal period. It seems that the best gestational age to be born is at 39 to 40 weeks of gestation. Mode of delivery at term counts as well, showing that vaginal delivery at term had the lowest risk of morbidity and mortality. How to cite this article Stanojevic M, Leko L. Early Neonatal Morbidity after Term Delivery: How should We respond? Donald School J Ultrasound Obstet Gynecol 2016;10(2):180-184.

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An observational study of early neonatal outcome in babies born to mothers with pregnancy induced hypertension

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20203176 ◽

2020 ◽

Vol 7 (8) ◽

pp. 1781

Author(s):

Ramya C. ◽

Rathna Kumari ◽

Charishma Chitneni

Keyword(s):

Preterm Delivery ◽

Neonatal Outcome ◽

Mode Of Delivery ◽

Neonatal Morbidity ◽

Morbidity And Mortality ◽

Control Group ◽

P Value ◽

Tertiary Center ◽

Group A ◽

Group B

Background: Hypertensive disorders in pregnancy are a major cause of maternal morbidity and mortality accounting for 15-20% of maternal deaths worldwide. In India the incidence of preeclampsia is reported to be 8-10 percent of the pregnancies objective of this study was to with the above background, this study was carried out to study early neonatal outcome in babies born to PIH mothers, Measure the adverse neonatal outcomes in the early neonatal period and compare the mode of delivery between control group and PIH group.Methods: A total of 58 neonates born to mothers diagnosed having gestational hypertension, preeclampsia, eclampsia were taken as tests (group A), and 100 apparently healthy newborns born to normotensive mothers were enrolled as controls (group B) and followed up to 1st week of life. The outcome measures were compared between groups in terms of mode of delivery, preterm delivery, birth weight, APGAR score, intra uterine growth retardation, early neonatal complications.Results: In group A, 33 had LBW (56.89%) and in group B 18 had LBW (18%). The incidence of preterm deliveries in group A was higher as compared to group B (A- 43.10%, B-17%, p value <0.05). Babies born to PIH mothers had an increased incidence of IUGR, as compared to group B.Conclusions: PIH is one of the major causes of maternal, fetal and early neonatal morbidity and mortality. In this study authors found that risk of LBW, preterm delivery, NICU admission and IUGR in babies born to PIH mothers statistically significant. Early detection of high-risk individual by well trained personnel and timely referral to advanced tertiary center is necessary in bringing down the maternal and neonatal morbidity and mortality.

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The Risks of Advancing Parental Age on Neonatal Morbidity and Mortality are U- or J-Shaped for Both Maternal and Paternal Ages.

10.21203/rs.3.rs-38033/v1 ◽

2020 ◽

Author(s):

James Thompson

Keyword(s):

United States ◽

Neonatal Mortality ◽

Maternal Age ◽

Neonatal Intensive Care ◽

Neonatal Morbidity ◽

The United States ◽

Paternal Age ◽

Morbidity And Mortality ◽

Very Preterm ◽

Prolonged Ventilation

Abstract Background: The biologic implications of delayed parenthood have been blamed for a major public health crisis in the United States, that includes high rates of neonatal morbidity and mortality (NMM). The objective of this study was to evaluate the risk of parent age on NMM and to provide results that can serve as a starting point for more specific mediation modeling. Methods: Data containing approximately 15,000,000 birth records were obtained from the United States Natality database for the years 2014 to 2017. A Bayesian modeling approach was used to estimate the both the total effect and the risk adjusted for confounding between parent ages and for mediation by chromosomal disorders including Down syndrome. Outcomes included neonatal mortality and nine measures of neonatal morbidity.Results: For paternal age, seven NMM (preterm birth, very preterm birth, low Apgar score, treatment with antibiotics, treatment with surfactant, prolonged ventilation, neonatal mortality) had U-shaped risk patterns, two NMM (small for gestational age, admission to neonatal intensive care) had J-shaped risk patterns, one NMM (seizures) was not significantly related to paternal age. For maternal age, three NMM (low Apgar score, treatment with antibiotics and neonatal mortality) had U-shaped risk patterns, four NMM (preterm delivery, very preterm delivery, admission to neonatal intensive care, treatment with surfactant) had J-shaped risk patterns, one NMM (small for gestational age) had a risk declining with age, one NMM (prolonged ventilation) had a risk increasing with age and one NMM (seizures) was not significantly related to maternal age. Conclusions. Under the assumptions of a specific causal model, both advancing maternal and paternal ages had U- or J-shaped risk patterns for neonatal morbidity and mortality.

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