Perinatal outcomes of spontaneous and medically-indicated late preterm infants

Abstract

Objective: The aim of the study was to compare the perinatal results of spontaneous and medically-indicated late-preterm infants. Methods:We conducted a retrospective cohort study including all singleton late-preterm infants born at our University Hospital between January 2009 and December 2010 (n=171). Neonates with congenital infections, major congenital malformations and chromosomal abnormalities were excluded. Late-preterm infants were classified into two groups, spontaneous and medically-indicated, according to delivery indication. Obstetric complications and short-term neonatal outcomes were investigated.Results: 145 late-preterm infants were eligible for analysis. Obstetric complications were more frequent in medically-indicated late-preterm infants. However, when neonatal results were compared no differences were found between groups. Both spontaneous and medically-indicated late-preterm infants were at risk to develop respiratory morbidity (14.5% vs 24.2%, p=0.195), hyperbilirubinemia (15.7% vs 11.3%, p=0.478), excessive weight loss (2.4% vs 4.8%, p =0.651), infectious complications (1.2% vs 8.1%, p =0.084) and central nervous system morbidity (2.4% vs 0%, p=0.507). Only length of hospital stay was significantly higher among medically-indicated late-preterm infants.Conclusions: Both spontaneous and medically-indicated late-preterm infants are at risk for perinatal morbidity. Obstetric management of pregnancies at risk for late-preterm prematurity should be clarified, and specific strategies of care for these infants need to be improved.

Maternal and Perinatal Determinants of Late Hospital Discharge Among Late Preterm Infants; A 5-Year Cross-Sectional Analysis

“…Most LPIs who developed these complications stayed at the NICU beyond 3 days. This finding is not different from the mounting reports published previously from all over the world which indicated that LPIs have more complications than term infants ( 5 , 32 , 33 ). The rates of hypoglycemia (1.8%) and hypothermia (<1%) among our cohort were much lower than other studies ( 7 , 8 ).…”

“…The majority of LPIs are delivered to mothers who present with preterm labor or with premature rupture of membranes ( 4 ). Still, some LPIs are delivered due to other obstetric medical indications related to the mother or the fetus including antepartum hemorrhage, hypertension, gestational diabetes mellitus, multiple gestations, and intrauterine growth restriction ( 5 ). The increasing rates of assisted pregnancy, labor induction, and elective Cesarean section (CS) delivery have contributed to the increase in the rate of LPI delivery as well ( 4 , 6 ).…”

“…Several reports have studied the maternal and fetal risk factors associated LPI delivery. Other reports focused on the perinatal outcomes of LPIs according to indication for delivery ( 5 , 11 ).…”