N KZN TERM X RESP MORBIDITY

Early term delivery is associated with increased neonatal respiratory morbidity

Ozgul Bulut 

 

Background

The recent increase in early term birth rates represents a growing challenge to public health given the association between early term birth and neonatal morbidities. We compared the risk of respiratory morbidity between early term and full term infants.

Methods

This retrospective cohort population study included infants born at 37–41 weeks’ gestation in a single tertiary care university hospital between 2014 and 2016. Newborns were categorized as early term (37–38 weeks) and full term (39–41 weeks). The primary outcome was respiratory morbidity.

Results

Of the 4,894 babies born at 37–41 weeks of gestational age, 31% (n = 1,521) were early term births. The rate of cesarean deliveries, which were often elective, was higher for early term than for full term newborns (p = 0.001). Compared with full term newborns, early term newborns, had significantly higher risks of respiratory morbidity (13.2 % vs. 6.3 %; odds ratio [OR], 2.28, p = 0.001), respiratory distress syndrome (2.0 % vs. 0 %, p = 0.001), transient tachypnea of the newborn (11.6 % vs. 4.6 %; OR, 2.72, p = 0.001), continuous positive airway pressure use (9.7 % vs. 3.7 %; OR, 2.82, p = 0.001), and ventilation support (1.4% vs. 0.4%; OR, 4.11, p = 0.001).

Conclusion

The elevated frequency of respiratory morbidity in early term infants emphasizes the importance of early term birth interventions. More than half of the early term births were elective cesarean sections; therefore, interventions should focus on reducing elective cesarean procedures at the time of first birth.