晚期早产和早期足月产的新生儿结局

Neonatal outcomes of late preterm and early term birth.

作者信息

Machado Luis C, Passini Renato, Rosa Izilda R, Carvalho Heráclito B

机构信息

Campinas State Universtity (Unicamp), School of Medicine, Department of Obstetrics and Gynecology, Rua Alexandre Benois, 180/101, São Paulo 05729-090, Brazil.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2014 Aug;179:204-8. doi: 10.1016/j.ejogrb.2014.04.042. Epub 2014 Jun 5.

DOI:10.1016/j.ejogrb.2014.04.042

PMID:24975646

Abstract

OBJECTIVE

To compare neonatal deaths and complications in infants born at 34-36 weeks and six days (late preterm: LPT) with those born at term (37-41 weeks and six days); to compare deaths of early term (37-38 weeks) versus late term (39-41 weeks and six days) infants; to search for any temporal trend in LPT rate.

STUDY DESIGN

A retrospective cohort study of live births was conducted in the Campinas State University, Brazil, from January 2004 to December 2010. Multiple pregnancies, malformations and congenital diseases were excluded. Control for confounders was performed. The level of significance was set at p<0.05.

RESULTS

After exclusions, there were 17,988 births (1653 late preterm and 16,345 term infants). A higher mortality in LPT versus term was observed, with an adjusted odds ratio (OR) of 5.29 (p<0.0001). Most complications were significantly associated with LPT births. There was a significant increase in LPT rate throughout the study period, but no significant trend in the rate of medically indicated deliveries. A higher mortality was observed in early term versus late term infants, with adjusted OR: 2.43 (p=0.038).

CONCLUSION

LPT and early term infants have a significantly higher risk of death.

摘要

目的

比较孕34周零天至36周零6天出生的晚期早产儿（LPT）与足月儿（孕37周零天至41周零6天）的新生儿死亡情况及并发症；比较早期足月儿（孕37 - 38周）与晚期足月儿（孕39 - 41周零6天）的死亡情况；探寻LPT发生率的任何时间趋势。

研究设计

对巴西坎皮纳斯州立大学2004年1月至2010年12月期间的活产进行回顾性队列研究。排除多胎妊娠、畸形和先天性疾病。对混杂因素进行了控制。显著性水平设定为p<0.05。

结果

排除后，共有17988例出生（1653例晚期早产儿和16345例足月儿）。观察到LPT组的死亡率高于足月儿组，调整后的优势比（OR）为5.29（p<0.0001）。大多数并发症与LPT出生显著相关。在整个研究期间，LPT发生率显著增加，但医学指征分娩率无显著趋势。早期足月儿的死亡率高于晚期足月儿，调整后的OR为2.43（p = 0.038）。