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早期足月婴儿(37或38周出生)的短期结局:一项回顾性调查。

Short-term outcomes in early term infants (born at 37 or 38 weeks): a retrospective investigation.

作者信息

Kitamura Tsubasa, Tabata Kyosuke, Murano Yayoi, Yoneoka Daisuke, Nakazawa Tomoyuki, Sakamaki Ken, Shoji Hiromichi

机构信息

Division of Obstetrics and Gynecology, Tokyo Metropolitan Toshima Hospital, Tokyo, Japan.

Division of Pediatrics, Tokyo Metropolitan Toshima Hospital, Tokyo, Japan.

出版信息

Front Pediatr. 2024 Oct 10;12:1430364. doi: 10.3389/fped.2024.1430364. eCollection 2024.

Abstract

INTRODUCTION

Recently, researchers have introduced the concept of 'early term' infants, defined as infants born at 37 or 38 weeks of gestation, and their outcome has been discussed. Although the complications experienced by early term are less severe than those in preterm infants, this group accounts for a much larger proportion of newborns, making the assessment of outcomes important in clinical practice.

METHODS

This observational study of term infants born at Tokyo Metropolitan Toshima Hospital aimed to understand the short-term outcomes in early term infants. Data extracted from the medical records were analyzed.

RESULTS

Among 4,669 eligible participants, 463 (9.9%) were born at 37 weeks and 1,270 (27.2%) were born at 38 weeks. The remaining 2,936 infants were born after 39 weeks of gestation. Logistic regression analysis showed higher odds ratio of hospitalization (1.56, 95% CI: 1.37-1.79,  < 0.05), apnea (2.23, 95%CI: 1.08-4.60,  < 0.05), and hypoglycemia (3.13, 95%CI: 1.95-5.03,  < 0.05) in early term infants. In detail, infants born at 37 weeks of gestational age had higher odds ratio for hospitalization (2.07, 95%CI: 1.68-2.35,  < 0.05) and hypoglycemia (4.11, 95%CI 2.22-7.60,  < 0.05) than infants born at 38 weeks of gestational age (1.40, 95%CI: 1.20-1.62,  < 0.05, and 2.78, 95%CI: 1.66-4.67,  < 0.0 respectively).

DISCUSSION

This study revealed complicated clinical course in early term infants, and represents one of the largest contributions to understanding the outcomes of early term infants, and could help to determine strategies for elective cesarean section. According to this result, elective cesarean sections would be better planned at 38 weeks of gestational age. Moreover, in clinical practice, it is important to be aware of the complicated clinical course in early term infants.

摘要

引言

最近,研究人员引入了“近足月”婴儿的概念,即妊娠37或38周出生的婴儿,并对其结局进行了讨论。尽管近足月婴儿经历的并发症不如早产儿严重,但这一群体在新生儿中所占比例要大得多,因此在临床实践中评估其结局很重要。

方法

这项对东京都丰岛医院出生的足月儿进行的观察性研究旨在了解近足月婴儿的短期结局。对从病历中提取的数据进行了分析。

结果

在4669名符合条件的参与者中,463名(9.9%)在37周出生,1270名(27.2%)在38周出生。其余2936名婴儿在妊娠39周后出生。逻辑回归分析显示,近足月婴儿住院(比值比1.56,95%置信区间:1.37 - 1.79,P < 0.05)、呼吸暂停(比值比2.23,95%置信区间:1.08 - 4.60,P < 0.05)和低血糖(比值比3.13,95%置信区间:1.95 - 5.03,P < 0.05)的比值比更高。具体而言,孕37周出生的婴儿住院(比值比2.07,95%置信区间:1.68 - 2.35,P < 0.05)和低血糖(比值比4.11,95%置信区间2.22 - 7.60,P < 0.05)的比值比高于孕38周出生的婴儿(分别为1.40,95%置信区间:1.20 - 1.62,P < 0.05和2.78,95%置信区间:1.66 - 4.67,P < 0.05)。

讨论

本研究揭示了近足月婴儿复杂的临床过程,是对理解近足月婴儿结局的最大贡献之一,有助于确定选择性剖宫产的策略。根据这一结果,选择性剖宫产最好计划在孕38周进行。此外,在临床实践中,了解近足月婴儿复杂的临床过程很重要。

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