TY - JOUR
T1 - Neonatal complications of term pregnancy
T2 - Rates by gestational age increase in a continuous, not threshold, fashion
AU - Caughey, Aaron B.
AU - Washington, A. Eugene
AU - Laros, Russell K.
N1 - Funding Information:
Supported in part by the National Institute of Child Health and Human Development, grant # HD01262 (A.B.C.).
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2005/1
Y1 - 2005/1
N2 - The purpose of this study was to determine whether, when, and how rates of short-term neonatal complications increase beyond 37 weeks of gestation. A retrospective cohort study was conducted of all low-risk, term, cephalic, and singleton births that were delivered at the University of California, San Francisco, between 1976 and 2001. Primary outcomes included neonatal umbilical artery pH, umbilical artery base excess, the presence of meconium, macrosomia, 5-minute Apgar scores, and admission to the intensive care nursery. Multivariate analyses were performed that controlled for maternal ethnicity, weight, age, socioeconomic status, and obstetric history. Among the 32,679 women who were delivered at ≥37 completed weeks of gestation, the rates of umbilical artery pH <7.0, umbilical artery base excess less than -12 increased beyond 40 weeks of gestation, and the presence of meconium increased beyond 39 weeks of gestation (chi-squared test; P <. 001). These outcomes continued to increase in each subsequent week, and these findings persisted when they were controlled for potential confounders in multivariate models. We found that the rates of immediate neonatal morbidity increase with increasing gestational age. Accurate determination of these rates is important in the determination of gestational age at which the risk of continuing the pregnancy outweighs the risk of induction of labor.
AB - The purpose of this study was to determine whether, when, and how rates of short-term neonatal complications increase beyond 37 weeks of gestation. A retrospective cohort study was conducted of all low-risk, term, cephalic, and singleton births that were delivered at the University of California, San Francisco, between 1976 and 2001. Primary outcomes included neonatal umbilical artery pH, umbilical artery base excess, the presence of meconium, macrosomia, 5-minute Apgar scores, and admission to the intensive care nursery. Multivariate analyses were performed that controlled for maternal ethnicity, weight, age, socioeconomic status, and obstetric history. Among the 32,679 women who were delivered at ≥37 completed weeks of gestation, the rates of umbilical artery pH <7.0, umbilical artery base excess less than -12 increased beyond 40 weeks of gestation, and the presence of meconium increased beyond 39 weeks of gestation (chi-squared test; P <. 001). These outcomes continued to increase in each subsequent week, and these findings persisted when they were controlled for potential confounders in multivariate models. We found that the rates of immediate neonatal morbidity increase with increasing gestational age. Accurate determination of these rates is important in the determination of gestational age at which the risk of continuing the pregnancy outweighs the risk of induction of labor.
KW - Perinatal morbidity
KW - Postdates pregnancy
KW - Postterm pregnancy
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U2 - 10.1016/j.ajog.2004.06.068
DO - 10.1016/j.ajog.2004.06.068
M3 - Article
C2 - 15672023
AN - SCOPUS:12844259698
VL - 192
SP - 185
EP - 190
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 1
ER -