Impact of restricting early-term deliveries on adverse neonatal outcomes: a statewide analysis

Cochrane, Anna C.; BATSON, Ryan; Aragon, Meredith; BEDENBAUGH, Molly; SELF, Stella; Eichelberger, Kacey Y.; ISHAM, Katheryn

doi:10.1016/j.ajogmf.2022.100797

Cited by 1 publication

(1 citation statement)

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“…This evidence of an association between early-term birth and adverse health outcomes in terms of growth and nutrition is intriguing. As we know, the evidence supporting the decision to advocate for deliveries at 39 weeks or later primarily arises from (1) the correlation between early-term births and increased risks of neonatal morbidity, mortality, hospitalization, and extended hospital stays [ 11 , 25 ] and (2) impaired long-term neurological development in early-term infants compared to full-term infants [ 26 ]. However, this evidence lacks confirmation of the association between early-term birth and adverse outcomes in children’s growth and nutrition.…”

Section: Discussionmentioning

confidence: 99%

Association of early-term birth and breastfeeding practices with nutritional outcomes in singleton term infants: a multicenter cross-sectional study

Zhang,

Liu,

et al. 2024

Int Breastfeed J

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Background Limited research has explored the associations of gestational age (GA) and breastfeeding practices with growth and nutrition in term infants. Methods This multicenter cross-sectional study recruited 7299 singleton term infants from well-child visits in Shandong, China, between March 2021 and November 2022. Data on GA, gender, ethnicity, birth weight, parental heights, gestational diabetes and hypertension, age at visit, breastfeeding practices (point-in-time data at visit for infants < 6 months and retrospective data at 6 months for infants ≥ 6 months), complementary foods introduction, infant length and weight, were collected. 7270 infants were included in the analysis after excluding outliers with Z-scores of length (LAZ), weight or weight for length (WLZ) <-4 or > 4. Linear regression models adjused for covariates explored the impact of GA and breastfeeding practices on LAZ and WLZ, while logistic regression models evaluated their effect on the likelihood of moderate and severe stunting (MSS, LAZ<-2), moderate and severe acute malnutrition (MSAM, WLZ<-2) and overweight/obesity (WLZ > 2). Sensitivity analysis was conducted on normal birth weight infants (2.5–4.0 kg). Results Infants born early-term and exclusively breastfed accounted for 31.1% and 66.4% of the sample, respectively. Early-term birth related to higher WLZ (< 6 months: β = 0.23, 95% confidence interval (CI): 0.16, 0.29; ≥6 months: β = 0.12, 95% CI: 0.04, 0.20) and an increased risk of overweight/obesity throughout infancy (< 6 months: OR: 1.41, 95% CI 1.08, 1.84; ≥6 months: OR: 1.35, 95% CI 1.03, 1.79). Before 6 months, early-term birth correlated with lower LAZ (β=-0.16, 95% CI: -0.21, -0.11) and an increased risk of MSS (OR: 1.01, 95%CI 1.00, 1.02); Compared to exclusive breastfeeding, exclusive formula-feeding and mixed feeding linked to lower WLZ (β=-0.15, 95%CI -0.30, 0.00 and β=-0.12, 95%CI -0.19, -0.05, respectively) and increased risks of MSAM (OR: 5.57, 95%CI 1.95, 15.88 and OR: 3.19, 95%CI 1.64, 6.19, respectively). Sensitivity analyses confirmed these findings. Conclusions The findings emphasize the health risks of early-term birth and the protective effect of exclusive breastfeeding in singleton term infants, underscoring the avoidance of nonmedically indicated delivery before 39 weeks and promoting exclusive breastfeeding before 6 months.

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Section: Discussionmentioning

confidence: 99%