Donald School Journal of Ultrasound in Obstetrics and Gynecology

Register      Login

VOLUME 10 , ISSUE 2 ( April-June, 2016 ) > List of Articles

REVIEW ARTICLE

Early Neonatal Morbidity after Term Delivery: How should We respond?

Milan Stanojevic, Lana Leko

Keywords : Morbidity,Neonate,Term delivery

Citation Information : Stanojevic M, Leko L. Early Neonatal Morbidity after Term Delivery: How should We respond?. Donald School J Ultrasound Obstet Gynecol 2016; 10 (2):180-184.

DOI: 10.5005/jp-journals-10009-1465

License: CC BY-NC 4.0

Published Online: 00-06-2016

Copyright Statement:  Copyright © 2016; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

The aim of this retrospective study was to investigate the influence of gestational age and mode of delivery at term on early neonatal morbidity and mortality in a tertiary maternity center in a 10-year period.

Materials and methods

The data were derived from the medical records between January 1, 2005, and December 31, 2014, from the University Hospital “Sveti Duh,” Zagreb, Croatia. There were 30,363 live born term infants included in the study. The data from the medical records have been used to analyze their mode of delivery, morbidity, and mortality.

Results

Term newborn infants delivered by cesarean section (CS) had increased prevalence of lower Apgar scores, resuscitation, neonatal convulsions, and neonatal encephalopathy, respiratory pathology (except for amniotic fluid aspiration), and mechanical ventilation. Early and late neonatal deaths were more prevalent in term infants delivered by CS. The prevalence of birth trauma (except for facial nerve palsy) and hyperbilirubinemia was significantly increased in vaginally born neonates. The prevalence of perinatal infections was equal in both groups of infants. Morbidity and mortality of term newborn infants presented as prevalence per 1,000 live born, regardless of the mode of a delivery week by week from 37 through 41 weeks of gestation, were also investigated. The highest prevalence for most of the observed parameters were at 37 to 41 weeks of gestation, while the lowest prevalence was observed at a gestational age between 39 and 40 weeks. This was not the case for the 1st and the 5th minute 4 to 7 Apgar scores, birth injuries, respiratory pathology, and late neonatal deaths.

Conclusion

Early-term delivery was connected with more morbidity and mortality in the early neonatal period. It seems that the best gestational age to be born is at 39 to 40 weeks of gestation. Mode of delivery at term counts as well, showing that vaginal delivery at term had the lowest risk of morbidity and mortality.

How to cite this article

Stanojevic M, Leko L. Early Neonatal Morbidity after Term Delivery: How should We respond? Donald School J Ultrasound Obstet Gynecol 2016;10(2):180-184.


PDF Share
  1. Manipal Cervical Scoring System by transvaginal ultrasound in predicting successful labour induction. J Clin Diagn Res 2015 May;9(5):QC04-QC09.
  2. Fetal growth: a review of terms, concepts and issues relevant to obstetrics. Ultrasound Obstet Gynecol 2013 Feb;41(2):136-145.
  3. Prediction of fetal lung immaturity using gestational age, patient characteristics and fetal lung maturity tests: a probabilistic approach. Arch Gynecol Obstet 2010 Jan;281(1):15-21.
  4. Placental pathology in relation to stillbirth and neonatal outcome in an extremely preterm population: a prospective cohort study. Acta Obstet Gynecol Scand 2015 Jun;94(6):584-590.
  5. Validity of New Ballard Score until 7th day of postnatal life in moderately preterm neonates. Arch Dis Child Fetal Neonatal Ed 2009 Jan;94(1):F39-F44.
  6. Programming of stress pathways: a transgenerational perspective. J Steroid Biochem Mol Biol 2015 Oct 22;pii:S0960-0760(15)30110-2.
  7. Gestational age assessment in the newborn—a review. Internet J Pediatr Neonatol 2009;12(2). Available from: http://print.ispub.com/api/0/ispub-article/7783.
  8. Neonatal Encephalopathy and Cerebral Palsy: Defining the Pathogenesis and Pathophysiology. Washington, DC: The American College of Obstetricians and Gynecologists; 2003.
  9. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol 1976 Oct;33(10):696-705.
  10. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004 Jul;114(1):297-316.
  11. com/quickcalcs/contingency1/
  12. endmemo.com/statistics/cc.php
  13. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet 2014 Sep 6;384(9946):857-868.
  14. Birthweight centile charts from rural community-based data from southern India. Indian Pediatr 2013 Nov 8;50(11):1020-1024.
  15. Measurement of novel biomarkers of neuronal injury and cerebral oxygenation after routine vaginal delivery versus cesarean section in term infants. J Perinat Med 2014 Nov;42(6):705-709.
  16. Women are designed to deliver vaginally and not by cesarean section: an obstetrician's view. Neonatology 2015;107(1):8-13.
  17. Trends in all-cause mortality across gestational age in days for children born at term. PLoS One 2015 Dec 14;10(12):e0144754.
  18. Adverse neonatal outcomes associated with early-term birth. JAMA Pediatr 2013 Nov;167(11):1053-1059.
  19. Early term infants are at increased risk of requiring neonatal intensive care. World J Pediatr 2016 Feb;12(1):76-81.
  20. The respiratory consequences of early-term birth and delivery by caesarean sections. Paediatr Respir Rev 2015 Dec 23;pii:S1526- 0542(15)00151-7.
  21. Long-term cognitive and school outcomes of late-preterm and early-term births: a systematic review. Child Care Health Dev 2016 Feb 10. doi:10.1111/cch.12320.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.