The risk of neonatal respiratory morbidity according to the etiology of late preterm delivery
-
Sung Ae Kim
,
Byoung Jae Kim
Abstract
Objective:
The risk of neonatal respiratory morbidity between indicated deliveries vs. spontaneous deliveries has not been consistent in previous studies, in spite of the traditional belief that chronic intrauterine stress might have protective effect on fetal lung maturation. We hypothesized that the heterogeneous etiology of indicated preterm delivery may obscure the relationship between the etiologies of preterm birth and neonatal respiratory morbidity. To address this issue, we divided the indicated preterm birth (PTB) into medically-indicated (without fetal compromise) PTB and maternal/fetal-indicated PTB, and compared the neonatal respiratory morbidity according to the etiology of late PTB.
Study design:
Neonatal respiratory morbidities were examined in neonates who were delivered between 34+0 and 36+6 weeks of gestation according to the etiology of PTB: 1) medically-indicated PTB (but without fetal compromise), 2) maternal/fetal-indicated PTB, or 3) spontaneous PTB such as preterm labor or preterm premature rupture of membranes.
Results:
A total of 710 late preterm neonates were included in the study population, including 31 cases of medically-indicated PTB, 202 cases of maternal/fetal-indicated PTB, and 477 cases of spontaneous PTB. The rate of composite respiratory morbidity in cases of medically-indicated PTB is higher than both maternal/fetal-indicated PTB and spontaneous PTB (19% in medically-indicated PTB, 6% in maternal/fetal-indicated PTB, and 7% in spontaneous PTB). This difference between medically-indicated PTB and maternal/fetal-indicated PTB remained significant after adjustment for confounding variables.
Conclusion:
The medically-indicated PTB is associated with highest risk of neonatal respiratory morbidity in late PTB.
Funding source: Ministry of Health and Welfare
Award Identifier / Grant number: HI12C0768
Funding statement: This work was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (No. HI12C0768). The authors would like to thank Sohee Oh, PhD of the Department of Biostatistics in Seoul Metropolitan Government Seoul National University Boramae Medical Center for statistical advice.
Acknowledgments:
This work was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (No. HI12C0768). The authors would like to thank Sohee Oh, PhD of the Department of Biostatistics in Seoul Metropolitan Government Seoul National University Boramae Medical Center for statistical advice.
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2017 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- What’s new in preterm birth prediction and prevention?
- Academy’s Corner
- Antenatal corticosteroids: current controversies
- Review articles
- The safety of progestogen in the prevention of preterm birth: meta-analysis of neonatal mortality
- Cervical pessary for the prevention of preterm birth: is it of any use?
- Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability
- Highlight articles
- Placental malperfusion as a possible mechanism of preterm birth in patients with Müllerian anomalies
- Nifedipine increases fetoplacental perfusion
- Effect of sleep disorders on threatened premature delivery
- Risk of recurrent preterm birth among women according to change in partner
- Biomarkers of spontaneous preterm birth: a systematic review of studies using multiplex analysis
- Influence of transvaginal ultrasound examination on quantitative vaginal fibronectin measurements: a prospective evaluation study
- Evaluation of quantitative fFn test in predicting the risk of preterm birth
- The value of ultrasound measurement of cervical length and parity in prediction of cesarean section risk in term premature rupture of membranes and unfavorable cervix
- Comparison of the duo of insulin-like growth factor binding protein-1/alpha fetoprotein (Amnioquick duo+®) and traditional clinical assessment for diagnosing premature rupture of fetal membranes
- Efficacy of a prospective community-based intervention to prevent preterm birth
- Maternal complications in settings where two-thirds of extremely preterm births are delivered by cesarean section
- The risk of neonatal respiratory morbidity according to the etiology of late preterm delivery
- Thyroid dysfunction in preterm neonates exposed to iodine
- Congress Calendar
- Congress Calendar
Articles in the same Issue
- Frontmatter
- Editorial
- What’s new in preterm birth prediction and prevention?
- Academy’s Corner
- Antenatal corticosteroids: current controversies
- Review articles
- The safety of progestogen in the prevention of preterm birth: meta-analysis of neonatal mortality
- Cervical pessary for the prevention of preterm birth: is it of any use?
- Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability
- Highlight articles
- Placental malperfusion as a possible mechanism of preterm birth in patients with Müllerian anomalies
- Nifedipine increases fetoplacental perfusion
- Effect of sleep disorders on threatened premature delivery
- Risk of recurrent preterm birth among women according to change in partner
- Biomarkers of spontaneous preterm birth: a systematic review of studies using multiplex analysis
- Influence of transvaginal ultrasound examination on quantitative vaginal fibronectin measurements: a prospective evaluation study
- Evaluation of quantitative fFn test in predicting the risk of preterm birth
- The value of ultrasound measurement of cervical length and parity in prediction of cesarean section risk in term premature rupture of membranes and unfavorable cervix
- Comparison of the duo of insulin-like growth factor binding protein-1/alpha fetoprotein (Amnioquick duo+®) and traditional clinical assessment for diagnosing premature rupture of fetal membranes
- Efficacy of a prospective community-based intervention to prevent preterm birth
- Maternal complications in settings where two-thirds of extremely preterm births are delivered by cesarean section
- The risk of neonatal respiratory morbidity according to the etiology of late preterm delivery
- Thyroid dysfunction in preterm neonates exposed to iodine
- Congress Calendar
- Congress Calendar
