Aim:
To evaluate the neonatal outcomes of late preterm births (LBPs) according to etiologic subgroups and to evaluate if there is any association between birth indication and neonatal morbidity in late preterm births.
Material and Method:
Singleton pregnancies delivered between 340/7–366/7 weeks (34 weeks and 36 weeks 6 days of pregnancy) during a 3-year period at a tertiary care university hospital were studied. Indications for delivery were classified as either spontaneous or inducted with medical indication. Inducted with medi-cal indication LPBs were categorized as either evidence-based (EB) (eg. severe preeclampsia/eclampsia, HELLP syndrome, abnormal fetal test, placenta previa or placental abruption with vaginal bleeding, and unstable/worsening medical conditions) or non evidence-based (NEB) (mild preeclampsia, intrauterine growth restriction with normal fetal test, oligohydramnios with normal fetal test, and mild/stable medical conditions).
Results:
There were 179 LPBs; 118 (66%) spontaneous and 61 (34%) inducted with medical indication. 76% of spontaneous LPBs were preterm labor with intact membranes and 24% were premature preterm rupture of membranes. 52% of inducted with medical indication LPBs were EB and 48% were NEB. The frequencies of neonatal intensive care unit (NICU) admissions were similar between the groups. The only significant difference among indications was infection rates in NICU (7% in the spontaneous vs. 33% in the inducted with medical indication group; P<0.001). Women with NEB deliveries were significantly older (31,6 vs. 27,9; P=0,010). NICU admission rates were significantly higher in the EB group, when compared to the NEB group (40% vs. 7%; P=,003)
Conclusion:
Inducted with medical indication LPBs consist of almost one third of all LPBs and accompany high rates of neonatal infections. Also among inducted with medical indication LPBs, neonatal morbidity is higher in cases with EB indications, when compared with the NEB subgroup.
Keywords: Late Preterm Births, Iatrogenic, Spontaneous
