Abstract
Objective
To assess the prevalence and risk of adverse perinatal outcomes in early-term (37+0–38+6 weeks), full-term (39+0–40+6 weeks), late-term (41+0–41+6 weeks), and post-term (>42+0 weeks) deliveries with spontaneous labor onset.
Study design
A population-based cohort with data from the Medical Birth Registry Norway (MBRN)
and Statistics Norway (SSB) was conducted. The study population consisted of 665,244
women with cephalic singleton live births at term or post-term with spontaneous labor
onset during the period of 1999–2014 in Norway. Maternal, obstetric, and fetal characteristics
were obtained from the MBRN. Maternal education data were obtained from the SSB. The
prevalence rates of adverse perinatal outcomes for each gestational age (GA) group
were estimated. Inter-group differences were detected with Chi square tests. Multivariable
regression analysis adjusted for maternal age, educational level, smoking, parity,
maternal diabetes, and preeclampsia was used to assess adverse outcome prevalence
for early- late-, and post-term births compared to full-term births.
Results
Deliveries at early-term were associated with an increased prevalence of neonatal
jaundice, polyhydramnios, small for gestational age (SGA) status, respiratory support,
and neonatal intensive care unit (NICU) admission compared with deliveries at GAs
of 39–43 weeks (p < 0.001). Low 5-min Apgar scores and newborn antibiotic treatment occurred at an increased
prevalence in both early-term and post-term infants, relative to the full-term group
(p < 0.001). The prevalence of oligohydramnios, meconium-stained amniotic fluid, and newborn
birth injuries increased with increasing GA.
Conclusions
More perinatal morbidity was observed among early-term infants compared to infants
with later term deliveries, underscoring the need for cautious management of low-risk
early-term deliveries.
Keywords
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Article info
Publication history
Published online: February 18, 2020
Accepted:
February 15,
2020
Received in revised form:
February 13,
2020
Received:
September 1,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
