TY - JOUR
T1 - Post-term pregnancy is an independent risk factor for neonatal morbidity even in low-risk singleton pregnancies
AU - Linder, Nehama
AU - Hiersch, Liran
AU - Fridman, Elana
AU - Klinger, Gil
AU - Lubin, Daniel
AU - Kouadio, Franck
AU - Melamed, Nir
N1 - Publisher Copyright:
© Published by the BMJ Publishing Group Limited.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Objective To determine the independent association of post-term pregnancy with neonatal outcome in low-risk newborns. Design Retrospective cohort. Setting Tertiary university-affiliated medical centre. Patients All newborns of low-risk singleton pregnancies born at 39+0 to 44+0 weeks' gestation over a 5-year period. Exclusion criteria: multiple gestation, maternal hypertensive disorder, diabetes or cholestasis, placental abruption or intrapartum fever (>38°C), small for gestational age (<10th centile) and major congenital or chromosomal anomalies. Interventions None. Outcome measures Admission to the neonatal intensive care unit (NICU), hospital length of stay, 5-min Apgar score, birth trauma, respiratory, neurological, metabolic and infectious morbidities and neonatal mortality. The adverse outcome rate was compared among three groups based on gestational age at birth: post-term (≥42+0 weeks), late term (41+0 to 41+6 weeks) and full term (39+0 to 40+6 weeks). Results Of the 23 524 eligible neonates, 747 (3.2%) were born post-term, 4632 (19.7%) late term and 18 145 (77.1%) full term. Women in the post-term group versus the late-term group had a significantly higher rate of caesarean section (8.9% vs 5.6%, p<0.001) and operative vaginal delivery (9.6% vs 7.4%, p=0.024). Post-term pregnancy versus full-term pregnancy was associated with an increased risk of NICU admission (OR 2.0, 95% CI 1.4 to 2.8), respiratory morbidity (OR 2.2, 95% CI 1.3 to 3.8) and infectious morbidity (OR 1.88, 95% CI 1.32 to 2.69). Post-term pregnancy versus late-term pregnancy was similarly associated with an increased risk of NICU admission (OR 2.0, 95% CI 1.4 to 2.9), respiratory morbidity (OR 2.7, 95% CI 1.5 to 5.0) and infectious morbidity (OR 1.8, 95% CI 1.2 to 2.7) and with hypoglycaemia (OR 2.6, 95% CI 1.2 to 5.4). Post-term delivery was not associated with neonatal mortality. Conclusions Post-term pregnancy is an independent risk factor for neonatal morbidity even in low-risk singleton pregnancies.
AB - Objective To determine the independent association of post-term pregnancy with neonatal outcome in low-risk newborns. Design Retrospective cohort. Setting Tertiary university-affiliated medical centre. Patients All newborns of low-risk singleton pregnancies born at 39+0 to 44+0 weeks' gestation over a 5-year period. Exclusion criteria: multiple gestation, maternal hypertensive disorder, diabetes or cholestasis, placental abruption or intrapartum fever (>38°C), small for gestational age (<10th centile) and major congenital or chromosomal anomalies. Interventions None. Outcome measures Admission to the neonatal intensive care unit (NICU), hospital length of stay, 5-min Apgar score, birth trauma, respiratory, neurological, metabolic and infectious morbidities and neonatal mortality. The adverse outcome rate was compared among three groups based on gestational age at birth: post-term (≥42+0 weeks), late term (41+0 to 41+6 weeks) and full term (39+0 to 40+6 weeks). Results Of the 23 524 eligible neonates, 747 (3.2%) were born post-term, 4632 (19.7%) late term and 18 145 (77.1%) full term. Women in the post-term group versus the late-term group had a significantly higher rate of caesarean section (8.9% vs 5.6%, p<0.001) and operative vaginal delivery (9.6% vs 7.4%, p=0.024). Post-term pregnancy versus full-term pregnancy was associated with an increased risk of NICU admission (OR 2.0, 95% CI 1.4 to 2.8), respiratory morbidity (OR 2.2, 95% CI 1.3 to 3.8) and infectious morbidity (OR 1.88, 95% CI 1.32 to 2.69). Post-term pregnancy versus late-term pregnancy was similarly associated with an increased risk of NICU admission (OR 2.0, 95% CI 1.4 to 2.9), respiratory morbidity (OR 2.7, 95% CI 1.5 to 5.0) and infectious morbidity (OR 1.8, 95% CI 1.2 to 2.7) and with hypoglycaemia (OR 2.6, 95% CI 1.2 to 5.4). Post-term delivery was not associated with neonatal mortality. Conclusions Post-term pregnancy is an independent risk factor for neonatal morbidity even in low-risk singleton pregnancies.
KW - Neonatal complications
KW - post-term
KW - singleton
UR - http://www.scopus.com/inward/record.url?scp=85021166363&partnerID=8YFLogxK
U2 - 10.1136/archdischild-2015-308553
DO - 10.1136/archdischild-2015-308553
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AN - SCOPUS:85021166363
SN - 1359-2998
VL - 102
SP - F286-F290
JO - Archives of Disease in Childhood: Fetal and Neonatal Edition
JF - Archives of Disease in Childhood: Fetal and Neonatal Edition
IS - 4
ER -
