Early-term births associated with higher neonatal morbidity, shows study

Early-term births (37 to 38 weeks gestation) are associated with higher neonatal morbidity (illness) and with more neonatal intensive care unit (NICU) or neonatology service admissions than term births (39 to 41 weeks gestation), according to a study by Shaon Sengupta, M.D., M.P.H., now of the Children's Hospital of Philadelphia and formerly of the University at Buffalo, N.Y., and colleagues.

Researchers examined data over a three-year period from medical records of 33,488 live births at major hospitals in Erie County, N.Y., 29,741 at a gestational age between 37 to 41 weeks.

According to study results, 27 percent of all live births were early-term (birth at 37 to 38 weeks). In comparison with term newborns (birth at 39 to 41 weeks), early-term newborns had higher risks for birth complications, including: hypoglycemia (low blood sugar, 4.9 percent vs. 2.5 percent), NICU or neonatology service admission (8.8 percent vs. 5.3 percent), need for respiratory support (2.0 percent vs. 1.1 percent), and requirement for intravenous fluids (7.5 percent vs. 4.4 percent). Cesarean deliveries, common among early-term births (38.4 percent), posed a higher risk for NICU or neonatology admissions and morbidity compared with term births; NICU or neonatology admission was also more common in vaginal early-term births compared with term newborns.

"We conclude that early-term delivery is associated with greater morbidity and with increased admission to the NICU or neonatology service in a geographic area-based setting. This increased risk is more profound with cesarean section deliveries but exists for vaginal deliveries as well," the study concludes.