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.

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.

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.

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.

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.