The effect of gestational age on neonatal outcome in low-risk singleton term deliveries

Linder, Nehama; Hiersch, Liran; Fridman, Elena; Lubin, Daniel; Kouadio, Franck; Berkowicz, N.; Merlob, Paul; Melamed, Nir

doi:10.3109/14767058.2014.916266

Cited by 15 publications

(26 citation statements)

References 23 publications

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“…This is much lower than the 55 per 1000 births in the study of Linder et al. in a low‐risk population of infants born at 37–38 weeks of gestation in a third‐level hospital . Caughey and Musci found for 37 weeks of gestation 74 NICU admissions per 1000 live births, Parikh et al .…”

Section: Discussionmentioning

confidence: 74%

“…An Apgar score <7 at 5 minutes was found in our study for 14.2 per 1000 live births at 37 weeks of gestation. Other studies were not comparable because of a low‐risk setting or because the study pertains to a regional cohort …”

Section: Discussionmentioning

confidence: 99%

“…Term birth is considered low risk when risk factors such as multiple pregnancy, fetal growth restriction, congenital malformations, hypertensive disorders, diabetes and/or complicated obstetric history are absent . However, term births are not a homogeneous group, and those born in the early‐term period, 37–38 weeks, are known to have a higher risk of mortality and morbidity than infants born at 39–41 weeks of gestation …”

Section: Introductionmentioning

confidence: 99%

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The risk of intrapartum/neonatal mortality and morbidity following birth at 37 weeks of gestation: a nationwide cohort study

Eskes

Ensing

Groenendaal

et al. 2019

BJOG

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Objective To assess intrapartum/neonatal mortality and morbidity risk in infants born at 37 weeks of gestation compared with infants born at 39–41 weeks of gestation. Design Nationwide cohort study. Setting The Netherlands. Population A total of 755 198 women delivering at term of a singleton without congenital malformations during 2010–14. Methods We used data from the national perinatal registry (PERINED). Analysis was performed with logistic regression and stratification for the way labour started and type of care. Main outcome measures Intrapartum or neonatal mortality up to 28 days and adverse neonatal outcome (neonatal mortality, 5‐minute Apgar <7, and/or neonatal intensive care unit admission). Results At 37 weeks of gestation intrapartum/neonatal mortality was 1.10‰ compared with 0.59‰ at 39–41 weeks (P < 0.0001). Adjusted odds ratio (aOR) for 37 weeks compared with 39–41 weeks was 1.84 (95% CI) 1.39–2.44). Adverse neonatal outcome at 37 weeks was 21.4‰ compared with 12.04‰ at 39–41 weeks (P < 0.0001) with an aOR 1.63 (95% CI 1.53–1.74). Spontaneous start of labour at 37 weeks of gestation was significantly associated with increased intrapartum/neonatal mortality with an aOR of 2.20 (95% CI 1.56–3.10), in both primary (midwifery‐led) care and specialist care. Neither induction of labour nor planned caesarean section showed increased intrapartum/neonatal mortality risk. Conclusions Birth at 37 weeks of gestation is independently associated with a higher frequency of clinically relevant adverse perinatal outcomes than birth at 39–41 weeks. In particular, spontaneous start of labour at 37 weeks of gestation doubles the risk for intrapartum/neonatal mortality. Extra fetal monitoring is warranted. Tweetable abstract Birth at 37 weeks of gestation gives markedly higher intrapartum/neonatal mortality risk than at 39–41 weeks, especially with spontaneous start of labour.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The risk of intrapartum/neonatal mortality and morbidity following birth at 37 weeks of gestation: a nationwide cohort study

Eskes

Ensing

Groenendaal

et al. 2019

BJOG

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show abstract

“…We estimate that this favorable result was due mainly to the higher gestational age at birth in the expectant management policy group. Generally, neonates born between 37 and 41 weeks of gestation are considered mature and low risk, but some recent researchers have pointed to a higher morbidity in early term neonates (37–38 weeks) . Linder et al .…”

Section: Discussionmentioning

confidence: 99%

“…Linder et al . conducted a retrospective cohort study of 30 229 low‐risk, singleton, term newborns and concluded that early term newborns are at higher risk for neonatal morbidity such as respiratory insufficiency, hypoglycemia, and jaundice . Sengupta et al .…”

Section: Discussionmentioning

confidence: 99%

Expectant management of pregnancies complicated by fetal growth restriction without any evidence of placental dysfunction at term: Comparison with routine labor induction

Hidaka

Sato

Kido

et al. 2017

J of Obstet and Gynaecol

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Aim: To assess the feasibility and practicality of expectant management for pregnancies with fetal growth restriction (FGR) at term without evidence of placental dysfunction. Methods: We reviewed the records of pregnancies with an estimated fetal weight ≤ 1.5 SD below the mean at 37 weeks of gestation. We excluded elective cesarean deliveries and pregnancies that, at 37 weeks, were complicated by oligohydramnios, decreased fetal cerebroplacental ratio, or pregnancy-related hypertensive disorders. Prior to May 2013, we performed routine labor induction for FGR at term; after that time, we used routine expectant management. The rate of delivery by cesarean or instrumental assist and the rate of neonatal morbidity were compared between the groups. Results: The gestational age at delivery and the neonatal birthweight were higher in the expectant management policy group (39 +4 vs 38 +1 weeks; 2405 vs 2205 g). The cesarean rate (7/77 vs 7/73) and the instrumental delivery rate (5/77 vs 6/73) did not differ. Neonatal hypoglycemia and hyperbilirubinemia were significantly less frequent (10/77 vs 21/73; 7/77 vs 20/73) in the expectant management policy group. Seven patients in the expectant management policy group underwent emergency cesarean delivery; five of these (71%) had required labor induction because of progression to oligohydramnios. Conclusions: Expectant management policy for FGR at term can reduce neonatal morbidity without increasing maternal risk or the cesarean rate. Caution should be used, however, during labor if oligohydramnios develops during expectant management.

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Rates of Neuropsychiatric Disorders and Gestational Age at Birth in a Danish Population

Xia

Xiao

et al. 2021

JAMA Netw Open

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IMPORTANCE Nonoptimal gestational durations could be associated with neurodevelopmental disabilities, yet evidence regarding finer classification of gestational age and rates of multiple major neuropsychiatric disorders beyond childhood is limited.OBJECTIVE To comprehensively evaluate associations between 6 gestational age groups and rates of 9 major types and 8 subtypes of childhood and adult-onset neuropsychiatric disorders.

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The effect of gestational age on neonatal outcome in low-risk singleton term deliveries

Abstract: Even in low-risk singleton deliveries, early term is associated with an increased risk of neonatal morbidity.

Cited by 15 publications

References 23 publications

The risk of intrapartum/neonatal mortality and morbidity following birth at 37 weeks of gestation: a nationwide cohort study

The risk of intrapartum/neonatal mortality and morbidity following birth at 37 weeks of gestation: a nationwide cohort study

Expectant management of pregnancies complicated by fetal growth restriction without any evidence of placental dysfunction at term: Comparison with routine labor induction

Rates of Neuropsychiatric Disorders and Gestational Age at Birth in a Danish Population

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