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  • Title: Perinatal morbidity associated with late preterm deliveries compared with deliveries between 37 and 40 weeks of gestation.
    Author: Cheng YW, Kaimal AJ, Bruckner TA, Halloran DR, Caughey AB.
    Journal: BJOG; 2011 Nov; 118(12):1446-54. PubMed ID: 21883872.
    Abstract:
    OBJECTIVE: To estimate the risk of short-term complications in neonates born between 34 and 36 weeks of gestation. DESIGN: This is a retrospective cohort study. SETTING: Deliveries in 2005 in the USA. POPULATION: Singleton live births between 34 and 40 weeks of gestation. METHODS: Gestational age was subgrouped into 34, 35, 36 and 37-40 completed weeks of gestation. Statistical comparisons were performed using chi-square test and multivariable logistic regression models, with 37-40 weeks of gestation designated as referent. MAIN OUTCOME MEASURES: Perinatal morbidities, including 5-minute Apgar scores, hyaline membrane disease, neonatal sepsis/antibiotics use, and admission to the intensive care unit. RESULTS: In all, 175,112 neonates were born between 34 and 36 weeks in 2005. Compared with neonates born between 37 and 40 weeks, neonates born at 34 weeks had higher odds of 5-minute Apgar <7 (adjusted odds ratio [aOR] 5.51, 95% CI 5.16-5.88), hyaline membrane disease (aOR 10.2, 95% CI 9.44-10.9), mechanical ventilation use >6 hours (aOR 9.78, 95% CI 8.99-10.6) and antibiotic use (aOR 9.00, 95% CI 8.43-9.60). Neonates born at 35 weeks were similarly at risk of morbidity, with higher odds of 5-minute Apgar <7 (aOR 3.42, 95% CI 3.23-3.63), surfactant use (aOR 3.74, 95% CI 3.21-4.22), ventilation use >6 hours (aOR 5.53, 95% CI 5.11-5.99) and neonatal intensive-care unit admission (aOR 11.3, 95% CI 11.0-11.7). Neonates born at 36 weeks remain at higher risk of morbidity compared with deliveries at 37-40 weeks of gestation. CONCLUSIONS: Although the risk of undesirable neonatal outcomes decreases with increasing gestational age, the risk of neonatal complications in late preterm births remains higher compared with infants delivered at 37-40 weeks of gestation.
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