Medically indicated late preterm delivery and its impact on perinatal morbidity and mortality: a retrospective population-based cohort study

2018 ◽  
Vol 32 (19) ◽  
pp. 3278-3287 ◽  
Author(s):  
Limor Besser ◽  
Liat Sabag-Shaviv ◽  
Maayan Yitshak-Sade ◽  
Salvatore Andrea Mastrolia ◽  
Danielle Landau ◽  
...  
Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Melissa Lorenzo ◽  
Megan Laupacis ◽  
Wilma M. Hopman ◽  
Imtiaz Ahmad ◽  
Faiza Khurshid

<b><i>Introduction:</i></b> Late preterm infants (LPIs) are infants born between 34<sup>0/7</sup> and 36<sup>6/7</sup> 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. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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 36<sup>0−6</sup> 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. <b><i>Discussion and Conclusion:</i></b> 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.


Author(s):  
Tetsuya Isayama ◽  
Daria O'Reilly ◽  
Joseph Beyene ◽  
Shoo K. Lee ◽  
Prakesh S. Shah ◽  
...  

Abstract Objective To compare admission and emergency visits of late preterm (340/7–366/7 weeks) versus term infants (370/7–416/7 weeks) in the first 5 years. Study Design This population-based cohort study included all singletons and twins born alive at 340/7 to 416/7 weeks' gestation registered in a health administrative database in Ontario, Canada, between April 1, 2002 and December 31, 2012. Admissions and emergency visits from initial postnatal discharge to 5 years were compared between late preterm and term infants adjusting for maternal and infant characteristics. Results A total of 1,316,931 infants (75,364 late preterm infants) were included. Late preterm infants had more frequent admissions than term infants in the first 5 years in both singletons (adjusted incidence rate ratio [95% confidence interval] = 1.46 [1.42–1.49]) and twins (1.21 [1.11–1.31]). The difference in admissions between late preterm and term infants were smaller in twins than singletons and decreased with children's ages. Twins had less frequent admissions than singletons for late preterm infants, but not for term infants. The emergency visits were more frequent in late preterm than term infants in all the periods. Conclusion Admissions and emergency visits were more frequent in late preterm than term infants through the first 5 years. Admissions were less frequent in late preterm twins than singletons.


PEDIATRICS ◽  
2006 ◽  
Vol 118 (2) ◽  
pp. 475-482 ◽  
Author(s):  
D. Hvidtjorn ◽  
J. Grove ◽  
D. E. Schendel ◽  
M. Vaeth ◽  
E. Ernst ◽  
...  

2019 ◽  
Vol 19 (3) ◽  
Author(s):  
Mohd. Andalas ◽  
Cut Rika Maharani ◽  
Evans Rizqan Hendrawan ◽  
Muhammad Reva Florean ◽  
Zulfahmi Zulfahmi

Abstrak. Ketuban Pecah Dini (KPD) atau Premature rupture of Membranes (PROM) merupakan pecahnya ketuban yang terjadi sebelum proses persalinan. Ketuban pecah dini terjadi sekitar 1% dari seluruh kehamilan. Ketuban pecah dini menyebabkan terjadinya 1/3 persalinan preterm dan merupakan penyebab 18%-20% dari morbiditas dan mortalitas perinatal. Dalam laporan kasus ini kami melaporkan seorang ibu hamil berusia 35 tahun, gravida 3, hamil aterm dengan ketuban pecah dini, keluhan keluar air dari jalan lahir dan belum inpartu. Laporan kasus ini bertujuan untuk meningkatkan kualitas diagnosa dini serta penatalaksanaan ketuban pecah dini untuk mengurangi risiko bagi ibu dan janin. Abstract.Premature Rupture of Membranes (PROM) is the rupture of amniotic sac prior to the onset of labor beyond 37 week of gestation. Premature Rupture of Membranes occurs in 1% ofall pregnancies. Premature Rupture of Membranes causes 1/3 preterm delivery and a major  18%-20% cause of perinatal morbidity and mortality. In this case report we reported a 35 year old woman with pregnant 3rd child, aterm wiht Premateur rupture of Membrane (PROM) and prior to labor. This report aims to improve the quality of early diagnosis and management of premature rupture of membranes to reduce the risk for the mother and fetus. 


2020 ◽  
Vol 226 ◽  
pp. 96-105.e7 ◽  
Author(s):  
Tetsuya Isayama ◽  
Daria O'Reilly ◽  
Joseph Beyene ◽  
Prakesh S. Shah ◽  
Shoo K. Lee ◽  
...  

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