Neonatal Intensive Care Unit, Department of Pediatrics, University of Patras Medical School, Rio, Patras, Greece.
Early Hum Dev. 2010 Sep;86(9):587-91. doi: 10.1016/j.earlhumdev.2010.07.011. Epub 2010 Aug 21.
To assess the effect of selected maternal medical conditions and complications of pregnancy on the risk for morbidity among late preterm neonates.
Prospective cohort study.
A total of 548 late preterm neonates (34(0/7) to 36(6/7)weeks' gestation) delivered from August 2006 to July 2009, were included. Information regarding demographics, gestational age, mode of delivery, maternal age and parity, pre-existing medical conditions and complications of pregnancy were obtained and associated with neonatal morbidity, both independently and as joint exposures. Newborn morbidity was defined by combining specific diagnoses, length of hospital stay, and transfer to the Neonatal Intensive Care Unit.
Overall, 165 (30.1%) of the late preterm infants suffered from morbidity. The morbidity rates were 16.8% at 36 weeks' gestation, and then approximately doubled from 38.2% at 35 weeks to 59.7% at 34 weeks. The joint effect of gestational age (OR 8.43 for 34 weeks and 3.60 for 35 weeks' gestation), small for gestational age (SGA) (OR 4.18), multiple gestation (OR 3.68) and lack of antenatal steroid administration (OR 4.03), was greater than the independent effect of each of these factors, and greater than additive. Emergency caesarean section (OR 1.43) and antepartum haemorrhage (OR 3.07) were also associated with a significant impact on neonatal morbidity.
The risk for morbidity among late preterm infants, changes with each passing week of gestation. This risk seems to be intensified, when other exposures such as SGA, multiple gestation, emergency caesarean section, lack of antenatal steroid administration and antepartum haemorrhage, are also present.
评估产妇的某些医疗状况和妊娠并发症对晚期早产儿发病风险的影响。
前瞻性队列研究。
共纳入 548 例晚期早产儿（34（0/7）至 36（6/7）周），分娩时间为 2006 年 8 月至 2009 年 7 月。收集人口统计学、胎龄、分娩方式、产妇年龄和产次、既往医疗状况和妊娠并发症等信息，并将其与新生儿发病情况进行独立和联合暴露关联分析。新生儿发病情况由特定诊断、住院时间和转入新生儿重症监护病房综合定义。
共有 165 例（30.1%）晚期早产儿发病。36 周时的发病比例为 16.8%，从 35 周时的 38.2%到 34 周时的 59.7%，发病率几乎翻了一番。胎龄（34 周时的 OR 8.43，35 周时的 OR 3.60）、小于胎龄儿（SGA）（OR 4.18）、多胎妊娠（OR 3.68）和缺乏产前皮质激素治疗（OR 4.03）的联合作用大于这些因素中任何一个的单独作用，且具有累加效应。急诊剖宫产（OR 1.43）和产前出血（OR 3.07）也与新生儿发病显著相关。
晚期早产儿的发病风险随胎龄的增加而变化。当存在其他因素，如 SGA、多胎妊娠、急诊剖宫产、缺乏产前皮质激素治疗和产前出血时，这种风险似乎会加剧。
