Late Preterm and Early Term Neonates: A New Group of High Risk Newborn in Neonatology with Varied Complications

Kumar, C Kishor

doi:10.4172/2167-0897.1000e112

Cited by 5 publications

(7 citation statements)

References 50 publications

(53 reference statements)

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“…Termination of women's pregnancies by elective caesarean section, especially before the 38 th week of pregnancy, most often results from medical indications [1,13,14,16], although it is emphasised that women increasingly demand such a method for terminating their pregnancy [14,16].…”

Section: Discussionmentioning

confidence: 99%

“…Abnormalities in the adaptation of newborns are frequently found following preterm birth or delivery by caesarean section at term, and many of these infants will need delivery room resuscitation to assist in this transition [5]. In recent years, there has been an almost two-fold increase in the frequency of elective terminations of pregnancies [1,6,12], not only among near-term newborns but also among early-term pregnancies [13,14]. It should be noted that additional risk factors affecting the infant's postnatal adaptation among these groups of newborns may be medical indications that induce obstetricians to terminate a pregnancy with an elective caesarean section before the 39 th week of its duration [1,15,16].…”

Section: Introductionmentioning

confidence: 99%

“…It should be noted that additional risk factors affecting the infant's postnatal adaptation among these groups of newborns may be medical indications that induce obstetricians to terminate a pregnancy with an elective caesarean section before the 39 th week of its duration [1,15,16]. The most common are complications during pregnancy or chronic maternal diseases [6,14]. Such pregnant patients are referred to a level III centre for perinatal care due to the need to protect the newborn where there is an intensive neonatal supervision department.…”

Section: Introductionmentioning

confidence: 99%

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Neonatal outcomes of elective caesarean section at 36 and 37 weeks compared with outcomes at 38 and 39 weeks

Czeszyńska¹,

Sochaczewska²,

Sontowska³

et al. 2018

polp

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Introduction: Not only late-preterm newborns but also those born as near-term are at increased risk of complications in the first hours of postnatal adaptation. Aim of the study: The aim of the retrospective study was to compare the postnatal status and adaptation disorders in neonates born with elective caesarean section at 36, 37, 38, and 39 weeks of pregnancy in a level-three perinatal care department. Material and methods: The research was carried out in a group of 200 newborns born in one year, 2015, and hospitalised from birth in the Department of Neonatology, Pomeranian Medical University in Szczecin. Postnatal status and occurrence of complications during the adaptation period were compared. The obtained results were compared between subgroups using appropriate statistical analysis methods. Results: In the group of newborns born in weeks 36 and 37 of pregnancy, significantly lower (p < 0.00001, p < 0.0002) birthweight (2688 g, 3208 g vs. 3524 g), lower Apgar score in the first and fifth minute of life (Me 9, 10 vs. 10; p < 0.00001, p < 0.05), and lower frequency of breastfeeding from birth (p < 0.0001, p < 0.002) were found in comparison to those born in the 39 th week of pregnancy (22%, 70% vs. 94%). In addition, the tendency for hypothermia was significantly more frequently (p < 0.001, p < 0.02) observed (36%, 26% vs. 8%), these newborns were more often required to stay in the observation room (80%, 28% vs. 8%; p < 0.0001, p < 0.01) and in the incubator (74%, 26% vs. 8%; p < 0.0001, p < 0.02), and significantly more often demonstrated symptoms of respiratory failure (48%, 18% vs. 4%; p < 0.0001, p < 0.05). The length of hospitalisation was also significantly longer (7.18, 5.42 vs. 4.46 days; p < 0.0002, p < 0.05). Conclusions: Due to the high risk of complications during the adaptation period, especially from the respiratory system, an elective caesarean section performed before the 38 th week of pregnancy is not an optimal solution for the newborn, unless there are important medical indications for such a termination of pregnancy. The most optimal term for elective caesarean section from the point of view of the newborn's interests is the 38 th or 39 th week of pregnancy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neonatal outcomes of elective caesarean section at 36 and 37 weeks compared with outcomes at 38 and 39 weeks

Czeszyńska¹,

Sochaczewska²,

Sontowska³

et al. 2018

polp

View full text Add to dashboard Cite

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“…Although preterm birth is defined as birth before 37 weeks of gestation, birth between 37 and 38 weeks of gestation (early‐term birth) is considered suboptimal. 2 Early‐term birth may increase the risk of mortality 3 and short‐term and long‐term morbidities, including respiratory, 4 , 5 , 6 allergic, 7 neurologic, 8 , 9 and metabolic disorders. 9 Risk factors of early‐term deliveries were reported as socioeconomic factors, environmental factors, pregnancy‐related complications, or medical indications; however, some of these deliveries were not medically indicated.…”

Section: Introductionmentioning

confidence: 99%

“…As the number of elective deliveries that are not medically indicated contributes to the growing proportion of early‐term births in the United States, 9 , 12 , 13 measures to reduce these deliveries have been undertaken in the country. Recent studies have reported a declining trend in early‐term birth rates.…”

Section: Introductionmentioning

confidence: 99%

Elective cesarean delivery at term and its effects on respiratory distress at birth in Japan: The Japan Environment and Children's Study

Horiuchi

Shinohara

Otawa

et al. 2021

Health Science Reports

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Background and Aims Early‐term birth between 37 and 38 weeks of gestation increases the risk of mortality and morbidity. This study investigated the status and impact of early‐term birth among neonates born by cesarean section in Japan. Methods All singleton live births that had data of gestational age at birth available in the Japan Environment and Children's Study (JECS), a nationwide birth cohort study launched in 2011, were eligible for this study. Neonates born by cesarean delivery at term without indications for early delivery were included to examine the association between early‐term birth and respiratory distress at birth. The gestational age at birth was categorized as 37 weeks 0 day to 38 weeks 6 days (early‐term), 39 weeks 0 day to 40 weeks 6 day (full‐term), and 41 weeks 0 day to 41 weeks 6 days (late‐term). Respiratory distress at birth included respiratory distress syndrome, transient tachypnea, and difficulty in breathing after birth. Univariable and multivariable analyses were performed using logistic regression models with a two‐tailed significance level of 5%. All statistical analyses were performed using SAS, version 9.4, for Windows (SAS Institute, Cary, NC). Results In total, 32 078 of 100 011 (32.1%) neonates had early‐term birth. At 37 gestational weeks, 49.7% of the deliveries were via cesarean section, and half of the cesarean deliveries were due to a previous cesarean section. Among the 10 051 neonates born by elective cesarean delivery at term, neonates with early‐term births were more likely to have respiratory distress at birth (adjusted odds ratio: 4.19; 95% confidence interval, 1.70, 10.34) than those born at full term. Conclusions Early‐term birth is associated with a high risk of respiratory distress in births involving cesarean delivery without indication for early delivery. There is a need for guidelines for early delivery considering adverse effects of early‐term births.

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Newborn Screening: Need of the Hour in India

et al. 2014

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After a review of the current health scene in India, the authors suggest that the Government of India should consider seriously, the introduction of new born screening. As a first step, a central advisory committee should be constituted to recommend what is required to be done to strengthen the infrastructure and the manpower to carry out new born screening, and the disorders to be screened. In the urban hospitals newborn screening (NBS) for three disorders can be easily introduced (congenital hypothyroidism, congenital adrenal hyperplasia and G-6-PD deficiency), while in the rural areas this should begin with congenital hypothyroidism, especially in the sub Himalayan areas. Concurrently, logistic issues regarding diets and special therapies for inborn errors of metabolism should be sorted out, laboratories to confirm the diagnosis should be set up, and a cadre of metabolic physicians should be build up to treat those identified to have inborn errors of metabolism. Once these are established on a firm footing, tandem mass spectrometry should be introduced as it allows the identification of a number of disorders in an affordable manner. The recent improvements and current trends in health care in India have created the necessary infrastructure for adopting NBS for the benefit of infants in India.

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Late Preterm and Early Term Neonates: A New Group of High Risk Newborn in Neonatology with Varied Complications

Cited by 5 publications

References 50 publications

Neonatal outcomes of elective caesarean section at 36 and 37 weeks compared with outcomes at 38 and 39 weeks

Neonatal outcomes of elective caesarean section at 36 and 37 weeks compared with outcomes at 38 and 39 weeks

Elective cesarean delivery at term and its effects on respiratory distress at birth in Japan: The Japan Environment and Children's Study

Newborn Screening: Need of the Hour in India

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