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Introduction: Moderate and late preterm and early-term infants constitute a significant proportion of hospitalizations in neonatal intensive care units (NICU), yet have been perceived as low-risk groups. Their gestational age-specific data have been poorly studied, including respiratory morbidity and outcome. Objectives: The objectives of this study were to determine the respiratory morbidity among moderate and late preterm and early-term infants and to study their short-term outcomes. Materials and Methods: A longitudinal descriptive hospital-based study was conducted at a tertiary care hospital in Southern India, from January 2018 to June 2019. Newborns between 32 and

Background: In the recent years, a high risk of developmental delay not only in very low birth weight infants and late preterm infants but also in early term infants (37–38 weeks) have increasingly been reported. However, in Japan, there are virtually no studies regarding the development delays in early term infants. Methods: This study used the data from the Japan Environment and Children's Study (JECS), a birth cohort study conducted in Japan. Data were selected for analysis from the records of 104,065 fetal records. The risk of neurodevelopmental delays at 6 months and 12 months after birth was evaluated using multivariate analysis for infants of various gestational ages, using the 40th week of pregnancy as a reference value. Neurodevelopment was evaluated at 6 months and 12 months after birth using the Ages and Stages Questionnaires, Japanese translation (J-ASQ-3). Results: The proportion of infants born at a gestational age of 37 to 38 weeks who did not reach the J-ASQ-3 score cutoff value was significantly higher in all areas at both 6 months and 12 months after birth, when compared to that of infants born at 40 weeks. The odds ratio decreased at 12 months after birth compared to that at 6 months after birth. Conclusion: Early term infants in Japan are at an increased risk of neurodevelopmental delay at 12 months after birth. Significance: What's known on this subject: Early term infants with gestational ages of 37 to 38 weeks and not only premature babies may be at an increased risk of developmental delay. What this study adds: This study was conducted using data from a birth cohort of 104,065 fetal records. Early term infants had an increased risk of developmental delay at 6 months, and while the risk decreased by 12 months after birth, it was still high. [ABSTRACT FROM AUTHOR]

Context Prematurity increases the long-term risks for endocrine and metabolic morbidity of offspring, but there is uncertainty regarding the risks for early-term deliveries (370/7-386/7 weeks of gestation). Objective We aim to evaluate whether early-term deliveries increase the long-term risk for type 1 diabetes and obesity of offspring up to the age of 18 years compared with full-term children. PubMed, Medline, and EMBASE were searched. Observational cohort studies addressing the association between early-term delivery and long-term risk for type 1 diabetes and obesity, were included. Two independent reviewers extracted data and assessed risk of bias. Pooled relative risks (RRs) and heterogeneity were determined. Publication bias was assessed by funnel plots with Egger's regression line and contours, and sensitivity analyses were performed. Results Eleven studies were included following a screen of 7500 abstracts. All studies were scored as high quality according to the Newcastle–Ottawa Quality Assessment Scale. Early-term delivery was significantly associated with an increased risk for type 1 diabetes (RR 1.19, 1.13-1.25), while the association was weaker for overweight and obesity (RR 1.05, 0.97-1.12). It is challenging to determine whether the association between early-term births and long-term morbidity represents a cause and effect relationship or is attributable to confounders. Most of the included studies adjusted for at least some possible confounders. Conclusion Compared with full-term offspring, early-term delivery poses a modest risk for long-term pediatric type 1 diabetes. Our analysis supports that, whenever medically possible, elective delivery should be avoided before 39 completed weeks of gestation. [ABSTRACT FROM AUTHOR]

IntroductionRecently, 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.MethodsThis 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.ResultsAmong 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, p

Aims: To compare obstetric and neonatal outcomes in patients with type 2 diabetes mellitus (T2DM) who had scheduled delivery at full term (≥ 39 0/7 weeks) compared to early term (37 0/7 – 38 6/7 weeks) for T2DM indications. Methods: This was a retrospective cohort study that included all singletons with T2DM with a scheduled delivery at a single tertiary care center between January 2008 and March 2022. Outcomes were compared using Fisher's exact test. Results: 107 singleton pregnancies were included. There was no significant difference in primary cesarean delivery between the two groups. The early term group had significantly higher rates of NICU admission compared to the term group (52% vs 32%, p = 0.05, OR 2.3, 95% CI 1.0–5.0), a finding that remained statistically significant on adjusted analysis (adjusted OR 2.81, 95% CI 1.04–7.58). Conclusions: In singleton pregnancies undergoing scheduled delivery for T2DM-specific indications, early term deliveries were associated with significantly increased odds of NICU admission when compared to term deliveries, even after adjusting for surrogate markers of glycemic control. These findings suggest that early term delivery contributes to risk of NICU admission, rather than the indication for delivery itself. These findings should be replicated in a larger cohort.

Objective Late preterm and early term deliveries are common in pregnancies complicated by diabetes due to higher rates of obstetric complications including increased stillbirth risk. However, early delivery is associated with multiple neonatal adverse outcomes, which may be further increased by maternal diabetes. We examined whether there is an additive effect on adverse neonatal outcomes in the setting of maternal diabetes in the late preterm and early term periods. Study Design This was a retrospective cohort study of women with a singleton, nonanomalous pregnancy delivering at a single academic medical center in the late preterm (34 0/7 –36 6/7 weeks) or early term (37 0/7 –38 6/7 weeks) period between 2010 and 2019. Women were categorized by diabetes status: no diabetes, type 1 (T1DM), type 2 (T2DM), or gestational diabetes (GDM). Multivariate logistic regression was used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for risk of both mild and severe composite neonatal outcome with delivery in the late preterm or early term period using pregnancies without diabetes as the referent. Results A total of 8,072 pregnancies were included with T1DM, T2DM, and GDM complicating 1.8, 5.6, and 9.9% of pregnancies, respectively. Expected demographic differences were seen among groups including higher rates of non-Hispanic Black race, chronic hypertension, and higher body mass index in women with T2DM. The probability of severe composite adverse neonatal outcome was significantly increased in women with T1DM in the late preterm (aOR: 4.4; CI: 2.4–8.1) and early term (aOR: 1.6; CI: 1.1–2.3) periods, largely driven by the need for mechanical ventilation. The mild composite outcome was increased among all women with diabetes with early term delivery but highest in women with T1DM. Conclusion Pregnancies complicated by diabetes, particularly T1DM, have higher rates of neonatal adverse outcomes independent of gestational age at delivery, which is an important consideration when late preterm or early term delivery is planned. Key Points Diabetes in pregnancy increases risk of early delivery. Adverse neonatal outcomes are higher with diabetes, especially T1DM. Adverse neonatal outcomes are independent of gestational age. [ABSTRACT FROM AUTHOR]

Early-term neonates (with a gestational age (GA) of 37 and 0/7 weeks to 38 and 6/7 weeks) face higher morbidities, including respiratory and neurodevelopmental issues, than full-term (39 and 0/7 weeks to 40 and 6/7 weeks) infants. This study explores whether hyperbilirubinemia necessitating phototherapy also differs between these groups. A retrospective study was conducted on neonates born from January 2021–June 2022, excluding those with specific conditions. Evaluated factors included GA, birth weight, bilirubin levels, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and feeding type, with phototherapy given as per AAP guidelines. Of 1085 neonates, 356 met the criteria. When stratifying the neonates based on the need for phototherapy, a higher proportion of early-term neonates required phototherapy compared to full-term (p < 0.05). After factoring in various risks (GA; birth weight; gender; feeding type; G6PD deficiency; transcutaneous bilirubin levels at 24 h and 24–48 h postpartum; maternal diabetes; and the presence of caput succedaneum or cephalohematoma), early-term neonates were more likely to need phototherapy than full-term babies (OR: 2.15, 95% CI: 1.21 to 3.80). The optimal cut-off for transcutaneous bilirubin levels 24–48 h postpartum that were used to predict phototherapy need was 9.85 mg/dl. In conclusion, early-term neonates are at a greater risk for developing jaundice and requiring phototherapy than full-term neonates. Monitoring bilirubin 24–48 h postpartum enhances early prediction and intervention. [ABSTRACT FROM AUTHOR]

Abstract Almost 30% of live births in England and Wales occur late preterm or early term (LPET) and are associated with increased risks of adverse health outcomes throughout the lifespan. However, very little is known about the decision-making processes concerning planned LPET births or the involvement of parents in these. This aim of this paper is to review the evidence on parental involvement in obstetric decision-making in general, to consider what can be extrapolated to decisions about LPET delivery, and to suggest directions for further research. A comprehensive, narrative review of relevant literature was conducted using Medline, MIDIRS, PsycInfo and CINAHL databases. Appropriate search terms were combined with Boolean operators to ensure the following broad areas were included: obstetric decision-making, parental involvement, late preterm and early term birth, and mode of delivery. This review suggests that parents’ preferences with respect to their inclusion in decision-making vary. Most mothers prefer sharing decision-making with their clinicians and up to half are dissatisfied with the extent of their involvement. Clinicians’ opinions on the limits of parental involvement, especially where the safety of mother or baby is potentially compromised, are highly influential in the obstetric decision-making process. Other important factors include contextual factors (such as the nature of the issue under discussion and the presence or absence of relevant medical indications for a requested intervention), demographic and other individual characteristics (such as ethnicity and parity), the quality of communication; and the information provided to parents. This review highlights the overarching need to explore how decisions about potential LPET delivery may be reached in order to maximise the satisfaction of mothers and fathers with their involvement in the decision-making process whilst simultaneously enabling clinicians both to minimise the number of LPET births and to optimise the wellbeing of women and babies.

Background: Late-preterm and early-term births constitute a significant proportion of live births. However, handwriting skills of these two populations remain unclear. We aimed to investigate their risk for poor Chinese handwriting in grade two. Methods: In this observational study, 185 second graders born late preterm (34+0–36+6 weeks' gestation, n = 54), early term (37+0–38+6 weeks' gestation, n = 56), and full term (39+0–41+6 weeks’ gestation, n = 75) without any intervention or diagnosis related to developmental delays were included. Their handwriting performance was rated by class teachers using the Chinese Handwriting Evaluation Form (CHEF), which is a standardized handwriting scale including five handwriting dimensions (construction, accuracy, directionality, speed, and pencil grasp). Results: After controlling for demographic risk factors, the late-preterm born group had a greater risk of having worse performance in the full form (adjusted odds ratio [aOR] = 3.93; p = .038) and construction dimension (aOR = 4.77; p = .009) of the CHEF than peers born at full term, whereas the risks were comparable for the early- and full-term born groups (aOR = 0.14–1.90; p = .073–0.453 in the handwriting dimensions). Conclusions: Late-preterm but not early-term born children were found to be at higher risk for poor Chinese handwriting in grade two. They particularly have difficulty with spatial construction including size, spacing, and alignment of Chinese characters and components that may influence handwriting legibility.

Late-preterm and early-term births constitute a significant proportion of live births. However, handwriting skills of these two populations remain unclear. We aimed to investigate their risk for poor Chinese handwriting in grade two. In this observational study, 185 second graders born late preterm (34+0–36+6 weeks' gestation, n = 54), early term (37+0–38+6 weeks' gestation, n = 56), and full term (39+0–41+6 weeks' gestation, n = 75) without any intervention or diagnosis related to developmental delays were included. Their handwriting performance was rated by class teachers using the Chinese Handwriting Evaluation Form (CHEF), which is a standardized handwriting scale including five handwriting dimensions (construction, accuracy, directionality, speed, and pencil grasp). After controlling for demographic risk factors, the late-preterm born group had a greater risk of having worse performance in the full form (adjusted odds ratio [aOR] = 3.93; p =.038) and construction dimension (aOR = 4.77; p =.009) of the CHEF than peers born at full term, whereas the risks were comparable for the early- and full-term born groups (aOR = 0.14–1.90; p =.073–0.453 in the handwriting dimensions). Late-preterm but not early-term born children were found to be at higher risk for poor Chinese handwriting in grade two. They particularly have difficulty with spatial construction including size, spacing, and alignment of Chinese characters and components that may influence handwriting legibility. [ABSTRACT FROM AUTHOR]

Introduction: prematurity is the first cause of neonatal and infant morbidity and mortality and shows complications, both in early term and late preterm neonates. Objective: to characterize the behavior of late preterm and early term neonates assisted at the Neonatology Service of the Mariana Grajales University Hospital of Gynecology and Obstetrics during the period from January to December 2019. Methods: an observational, descriptive and cross-sectional research was carried out from January to December 2019; the population consisted of 519 neonates. Results: maternal ages between 18 and 34 years of age predominated in both groups and the extreme ages in the early term group with respect to the late preterm group stood out. The most frequent neonatal morbidity in both groups was jaundice, physiological icterus aggravated by prematurity in the late preterm group and metabolic disorders in the early term group. Conclusions: the early term group predominated over the late preterm group. Male gender and low birth weight were more frequent in the late preterm group and female gender and normal weight in the early term group and almost all the newborns were alive at medical discharge. [ABSTRACT FROM AUTHOR]

Early-term neonates (with a gestational age (GA) of 37 and 0/7 weeks to 38 and 6/7 weeks) face higher morbidities, including respiratory and neurodevelopmental issues, than full-term (39 and 0/7 weeks to 40 and 6/7 weeks) infants. This study explores whether hyperbilirubinemia necessitating phototherapy also differs between these groups. A retrospective study was conducted on neonates born from January 2021–June 2022, excluding those with specific conditions. Evaluated factors included GA, birth weight, bilirubin levels, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and feeding type, with phototherapy given as per AAP guidelines. Of 1085 neonates, 356 met the criteria. When stratifying the neonates based on the need for phototherapy, a higher proportion of early-term neonates required phototherapy compared to full-term (p < 0.05). After factoring in various risks (GA; birth weight; gender; feeding type; G6PD deficiency; transcutaneous bilirubin levels at 24 h and 24–48 h postpartum; maternal diabetes; and the presence of caput succedaneum or cephalohematoma), early-term neonates were more likely to need phototherapy than full-term babies (OR: 2.15, 95% CI: 1.21 to 3.80). The optimal cut-off for transcutaneous bilirubin levels 24–48 h postpartum that were used to predict phototherapy need was 9.85 mg/dl. In conclusion, early-term neonates are at a greater risk for developing jaundice and requiring phototherapy than full-term neonates. Monitoring bilirubin 24–48 h postpartum enhances early prediction and intervention.

BACKGROUNDS: It was intended to compare early term babies to term babies by reviewing short-term issues and long-term neurodevelopmental evaluations. METHODS: It was planned as a prospective case-control study. Of the 4263 infants admitted to the neonatal intensive care unit, 109 infants born at early term by elective cesarean section and hospitalized within the first 10 postnatal days were included in the study. As the control group, 109 babies born at term were enrolled. Nutrition status of infants, reasons for hospitalization in the first postnatal week were recorded. When the babies were 18-24 months old, an appointment was made for neurodevelopmental evaluation. RESULTS: In the early term group, the time of breastfeeding was later than the control group, with a statistically significant difference. Similarly, breastfeeding difficulty, need for formula in the first week postpartum and hospitalization were found to be significantly higher in the early term group. Considering the short-term results; pathological weight loss, hyperbilirubinemia requiring phototherapy and feeding difficulties were statistically significantly higher in the early term group. Neurodevelopmental delay did not statistically differ across the groups, but the early term group's MDI and PDI scores were found to be statistically lower than those of the term group. CONCLUSION: Early term infants are thought to be like term infants in many ways. Although these babies are similar to term babies, they are still physiologically immature. The short and long-term negative consequences of early term birth are obvious, non-medical elective early term births should be prevented. [ABSTRACT FROM AUTHOR]

Background: Guidelines from prominent policymakers on the use of antenatal steroids (ANS) in "late preterm deliveries and early term casearian deliveries" (LET) are nonuniform. This descriptive study compared LET infants born during two-time epochs: Retrospective: ANS exposed (ANSE) (when institute practice was to administer ANS to all LET mothers), and prospective - ANS unexposed (ANSU) (after the policy was revised in May 2021). Methodology: All antenatal mothers of anticipated late-preterm and early-term cesarean deliveries were being administered ANS before May 2021. Following the revision of hospital policy, this practice was discontinued. Comparative analysis for respiratory morbidity (RM) and other clinically relevant outcomes were conducted in infants born during two-time epochs (ANSE vs. ANSU). Results: Among 379 included infants, those with RMs were comparable between groups: 33 (17.5%) in ANSE; 31 (16.4%) in ANSU - Odds ratio (OR) 1.08; 95% confidence interval (CI) (0.61-1.92), P = 0.78. No difference was noted in hypoglycemia events: 23 (12.2%) in ANSE; 22 (11.6%) in ANSU, OR = 1.05 95% CI (0.56-1.96), P = 0.87. Conclusion: ANS in LET did not seem to reduce the risk of RM. It may be appropriate to audit individual unit practices and relevant outcomes before blanket recommendations are made. [ABSTRACT FROM AUTHOR]

Objective In an attempt to avoid emergency deliveries of women with multiple prior scars, providers may choose to schedule those repeat cesarean births prior to 39 weeks. Our primary goal was to compare rates of assisted ventilation use between neonates with early term (37°-386 weeks) and full-term (39°–396 weeks) deliveries among women with three or more prior cesarean births. Methods A retrospective cohort study of women with three or more previous cesarean births. The study group consisted of women who delivered at early term (37°–386 weeks). The control group consisted of women who delivered at full term (39°–396 weeks gestation). Women with a history of pre-gestational diabetes, gestational hypertension and chronic hypertension were excluded. Data were extracted from the 2017 United States Natality database. Characteristics were compared between groups for potential confounders. Primary outcome, neonatal assisted ventilation use greater than 6 h, and other secondary outcomes (including immediate assisted ventilation in the neonate and uterine rupture) were compared between groups. Multivariable logistic regression analyses were performed to adjust for potential confounding factors between groups. Results A total of 28,584 women with three or more prior cesarean births were included. There were 12,391 women who delivered at early term, and 16,193 who delivered at full term. Neonates born from women who delivered at early term had an increased risk of assisted ventilation use greater than 6 h compared with neonates who delivered at full term (assisted ventilation greater than 6 h, adjusted odds ratio (aOR) 2.08, 95% confidence interval (CI) [1.59–2.73]). Neonates delivered at early term were also more likely to need immediate ventilation use than were neonates delivered at full term (aOR 1.52, 95% CI [1.33–1.73]). Women who delivered at early term had a higher rate of uterine rupture compared with women who delivered at full term (OR 5.67, 95% CI [2.33–13.79]). [ABSTRACT FROM AUTHOR]

Objective: Isolated oligohydramnios (IO) - oligohydramnios in the absence of maternal or gestational comorbidity is debated as an indication for induction of labor. Previous meta-analyses regarding perinatal outcomes of IO at term have yielded conflicting results. We aimed to investigate the neonatal outcomes among gestations with IO delivered at 36°/7-396/7. Methods: The study cohort included all women undergoing a trial of labor between during 2011 and 2019 of a singleton gestation with cephalic presentation between 36°/7 and 40°/7. We allocated the study groups into women with IO and those with normal amniotic fluid volume. Neonatal outcomes were compared between the groups and in relation to gestational age and induction of labor. Results: Overall, there were 529/17,709 (3.0%) IO cases. IO was associated with maternal age <25 years (OR [95% CI] 1.62 (1.20-2.20), p = .001). Induction of labor was more common with IO (OR [95% CI] 1.33 (1.05-1.69) p = .01. IO was associated with preterm delivery (OR [95% CI] 1.81 (1.36-2.40), p < .001). The rate of neonatal adverse outcome did not differ between study groups. Overall composite adverse neonatal outcome occurred among 1,399/17,709 (7.9%) deliveries. Adverse neonatal outcome was associated with induction of labor (OR [95% CI] 1.61 (1.40-1.86), p < .001) and low birth weight (OR [95% CI] 7.41 (6.27-8.75), p < .001). When Stratified by gestational age, neonatal adverse outcome did not differ between IO and no IO groups. When examining cases of induction of labor per gestational age, induction of labor at 36 weeks among IO gestations, was associated with adverse neonatal outcome as compared to no IO group (OR [95% CI] 5.7 (1.23-26.3), p = .04). Conclusions: Induction of labor in gestations complicated by IO at 36 weeks gestational age is associated with an increased risk for adverse neonatal outcome. Our study results adds to the current literature regarding outcomes of IO and time of delivery. [ABSTRACT FROM AUTHOR]

Breastfeeding involves signaling between mother and offspring through biological (breast milk) and behavioral pathways. This study tested this by examining the effects of a relaxation intervention in an understudied infant population. Breastfeeding mothers of late preterm (340/7–366/7 weeks) and early term (370/7–386/7 weeks) infants were randomized to the relaxation group (RG, n = 35), where they were asked to listen to a meditation recording while breastfeeding from 3 weeks post-delivery, or the control group (CG, n = 37) where no intervention was given. Primary outcomes-maternal stress and infant weight-were assessed at 2–3 (baseline) and 6–8 weeks post-delivery. Secondary outcomes included infant length, infant behavior, maternal verbal memory, salivary cortisol, and breast milk composition. Infants in the RG had significantly higher change in weight-for-age Z-score compared to those in CG (effect size: 0.4; 95% CI: 0.09, 0.71; p = 0.01), and shorter crying duration [RG: 5.0 min, 0.0–120.0 vs. CG: 30.0 min, 0.0–142.0; p = 0.03]. RG mothers had greater reduction in cortisol (effect size: −0.08 ug/dL, 95% CI −0.15, −0.01; p = 0.03) and better maternal verbal learning score (effect size: 1.1 words, 95% CI 0.04, 2.1; p = 0.04) than CG mothers, but did not differ in stress scores. A simple relaxation intervention during breastfeeding could be beneficial in promoting growth of late preterm and early term infants. Further investigation of other potential biological and behavioral mediators is warranted. [ABSTRACT FROM AUTHOR]

BackgroundBirth before 37 or beyond 42 gestational weeks is associated with adverse neonatal and maternal outcomes. Studies investigating determinants and outcomes of these deliveries are scarce. The objective of this study was to determine the neonatal birth profile in relation to the gestational age at delivery and to evaluate its influence on the immediate maternal and neonatal outcomes.MethodsThis is a multicenter cohort study of 13,403 women conducted in three hospitals in Riyadh. Collected data included sociodemographic characteristics, obstetric history, and physical and laboratory measurements. Regression models were developed to estimate the adjusted odds ratio (OR) and confidence intervals (CI) to determine factors associated with preterm, early term, and post-term births and to evaluate common maternal and neonatal risks imposed by deliveries outside the full term.ResultsThe incidence of preterm, early term, and post-term delivery was 8.4%, 29.8%, and 1.4%, respectively. Hypertensive events during pregnancy consistently increased the risk of all grades of preterm births, from more than 3-fold for late preterm (OR = 3.40, 95% CI = 2.21–5.23) to nearly 7-fold for extremely early preterm (OR = 7.11, 95% CI = 2.24–22.60). Early term was more likely to occur in older mothers (OR = 1.30, 95% CI = 1.13–1.49), grand multiparous (OR = 1.21, 95% CI = 1.06–1.38), pregestational diabetes (OR = 1.91, 95% CI = 1.49–2.44), and gestational diabetes women (OR = 1.18, 95% CI = 1.05–1.33). The risk of post-term birth was higher in primiparous. In preterm births, the adverse outcome of neonates having an APGAR score of

To identify when obstetricians would deliver a fetus with antenatal hydronephrosis and normal liquor. Designed as snap-shot survey. Setting: Survey Monkey link. Population/sample were obstetrics and fetal medicine consultants who received the survey link via closed professional forums on the North West Coast Maternity Clinical Network, Facebook, and publicly on Twitter. Survey link publicised as above, obstetric consultants were asked at what gestation would they deliver a fetus with antenatal hydronephrosis and normal liquor; and what criteria would they use to make that decision. Main outcome measures were number of years in practice, gestation at delivery, anteroposterior diameter (APD) of renal pelvis. A total of 44/102 respondents (43%) would deliver prior to 40 weeks (median no. of years as consultant 10 years [IQR 5–17]) vs. those who would not (median years as consultant 5.5 [IQR 3–12]). Re APD threshold of delivery: 17 indicated delivery if the APD were 20 mm, 10 if it were 21–30 mm and 16 if it were >30 mm. Re gestation at which they would deliver: 13 indicated 37–38 weeks, 13 indicated 38–39 weeks and 17 indicated 39–40 weeks. Reasons selected for delivery before term were obstetric anxiety n=2, maternal request n=2, maternal anxiety n=2 and concern about fatal renal damage/renal damage n=34. A surprising number of respondents would consider early delivery of a fetus with hydronephrosis and normal liquor despite the lack of evidence of benefit. The evidence supporting term delivery means that early term delivery is only indicated for obstetric reasons in this scenario. [ABSTRACT FROM AUTHOR]

Abstract Background Chorioamnionitis is a frequent complication of pregnancy and is known to be associated with serious adverse post-natal outcomes including death. However, the assessment of fetal well-being in labor in the context of chorioamnionitis is often challenging because of fetal tachycardia. Identifying specific risk factors for adverse neonatal outcomes in the context of chorioamnionitis could therefore be of paramount importance. This study aimed to determine if maternal and fetal risk factors for increased neonatal mortality and early neonatal mortality are modified in the context of chorioamnionitis in term pregnancies. Methods A retrospective population-based cohort study using the United States birth/infant death public file from 2011 to 2013 was performed, including all live births at 37 weeks gestation and beyond. Interaction between chorioamnionitis and maternal demographic variables as well as labor and delivery potential risk factors were analyzed for association with neonatal death ( 35 kg/m2), late or no prenatal care, diabetes, meconium-stained amniotic fluid, gestational ages other than 39 weeks, neonatal weight

Background: A multifaceted preterm birth (PTB) prevention initiative was launched in the Australian Capital Territory (ACT) in 2019. The aim of this initiative was to safely lower the rate of early births across the ACT and the surrounding areas in New South Wales. Modelled on the Western Australian PTB Prevention Initiative, the program included new clinical guidelines and a new PTB prevention clinic at the main tertiary hospital. Aim: To evaluate the initiative and its effects on preterm and early term birth rates at the main tertiary hospital after 16 months of implementation. Materials and Methods: A before and after intervention study was conducted. Rates of preterm and early term birth before (previous five years) and after 16 months of implementation of the ACT PTB Prevention Initiative were evaluated. Results: At the main tertiary hospital in The Canberra Hospital, the rate of PTB was significantly reduced by 10% after 16 months of implementation of the initiative. Rates of PTB were lower than any of the preceding five years and resulted in 45 averted or delayed PTBs. The number of planned early term births with no medical indication was significantly reduced by 34.5% and resulted in 77 averted or delayed early term births. Conclusions: The multifaceted PTB Prevention Initiative safely lowered the rates of early birth in the ACT context. These results highlight the importance of prioritising early birth prevention, education, research and expanding the initiative nationwide. [ABSTRACT FROM AUTHOR]

Objective  The aim of this study is to model the association between gestational age at birth and early child development through 3 years of age. Study Design  Development of 5,868 children in Upstate KIDS (New York State; 2008–2014) was assessed at 7 time points using the Ages and Stages Questionnaire (ASQ). The ASQ was implemented using gestational age corrected dates of birth at 4, 8, 12, 18, 24, 30, and 36 months. Whether children were eligible for developmental services from the Early Intervention Program was determined through linkage. Gestational age was based on vital records. Statistical models adjusted for covariates including sociodemographic factors, maternal smoking, and plurality. Results  Compared with gestational age of 39 weeks, adjusted odds ratios (aOR) and 95% confidence intervals of failing the ASQ for children delivered at <32, 32–34, 35–36, 37, 38, and 40 weeks of gestational age were 5.32 (3.42–8.28), 2.43 (1.60–3.69), 1.38 (1.00–1.90), 1.37 (0.98–1.90), 1.29 (0.99–1.67), 0.73 (0.55–0.96), and 0.51 (0.32–0.82). Similar risks of being eligible for Early Intervention Program services were observed (aOR: 4.19, 2.10, 1.29, 1.20, 1.01, 1.00 [ref], 0.92, and 0.78 respectively for <32, 32–34, 37, 38, 39 [ref], 40, and 41 weeks). Conclusion  Gestational age was inversely associated with developmental delays for all gestational ages. Evidence from our study is potentially informative for low-risk deliveries at 39 weeks, but it is notable that deliveries at 40 weeks exhibited further lower risk. [ABSTRACT FROM AUTHOR]

Introduction: Newborns having a gestational age between 37 to 416/7 weeks are defined as term newborn. The aim of the study was to investigate the rates and causes of hospitalization, and the differences in neonatal morbidities between early-term and full-term infants as a single-center experience in our hospital. Materials and Methods: This retrospective study was carried out in a tertiary neonatal intensive care unit between January 2013 and December 2014. Maternal characteristics and comorbidities; neonatal characteristics, length of hospital stay, and neonatal morbidities were recorded. Primary outcome measure was need for neonatal intensive care unit (NICU) admission. Results: Maternal comorbidities, ceserean delivery, low birth weight, SGA and multiple gestations were found to be higher in early-term infants and earlyterm infants were at higher risk for respiratory morbidities, respiratory support requirement, hypoglycemia and intravenous antibiotic therapy. After multivariate logistic regression analyses, only higher risk for respiratory morbidity persisted (OR:1.28 [1.02-1.59]; p=0.02). In contrast to that, full-term infants was found to be at higher risk for hypernatremia compared to early-term infants. Conclusions: Early term birth is associated with a higher neonatal morbidity and NICU admissions, and gestational age is known to be the most important determinant of this situation. With advanced maternal care and better understanding of the factors causing early term birth will lead to prevention and successfull management of this risk group. [ABSTRACT FROM AUTHOR]

Respiratory distress in late-preterm and early term infants generally may warrant admission to a special care nursery or an intensive care unit. In particular, respiratory distress syndrome and transient tachypnea of the newborn are the two most common respiratory morbidities. Antenatal corticosteroids (ACS) facilitate surfactant production and lung fluid resorption. The use of ACS has been proven to be beneficial for preterm infants delivered at less than 34 weeks’ gestation. Literature suggests that the benefits of giving antenatal corticosteroids may extend to late-preterm and early term infants as well. This review discusses the short-term benefits of ACS administration in reducing respiratory morbidities, in addition to potential long term adverse effects. An update on the current practices of ACS use in pregnancies greater than 34 weeks’ gestation and considerations of possibly extending versus restricting this practice to certain settings will also be provided. [ABSTRACT FROM AUTHOR]

Breastfeeding support is essential for mothers of late preterm and early term infants. Our aim was to compare breastfeeding data from mother--infant dyads of late preterm (33 to 36+6) and early term infants (37 to 37+6) related to referral and follow-up consults from visits to a Western Australian breastfeeding centre (BFC). A retrospective audit was conducted between December 2016 and May 2017 with mother--infant dyads of these two groups who birthed at a tertiary referral hospital, were discharged breastfeeding and referred to the BFC. The sample included 78 late preterm and 75 early term dyads. Differences in maternal reasons for BFC referrals confirmed mothers with late preterm infants experienced more attachment issues (p=0.002), whereas mothers of early term infants had more supply issues (p=0.000). Infant reasons for referral were comparable with attachment noted as greater than 80% across both groups. Late preterm infants had a longer length of hospital stay (p=0.001) and early term dyads had a shorter timeframe between request and first appointment at the BFC (mean 7.7 days vs 10.6 days; p=0.033). Identifying similarities and differences in breastfeeding practices can inform strategies to better address the breastfeeding support needs between these vulnerable dyads. [ABSTRACT FROM AUTHOR]

Background: Preterm birth is a major determinant of adverse health consequences, and early term births are also associated with increased risk of various outcomes. In light of climate change, the effect of ambient temperature on earlier delivery is an important factor to consider. Several studies have focused on associations of ambient air temperature (Ta) on preterm birth, but few have examined associations with early term births. Aims: To investigate the association of prenatal exposure to Ta with preterm birth (

Abstract Background The recommendation of non-indicated caesarean section (CS) after 39 gestational weeks has been announced based on evidence of maternal and infant physiological effects. The potential psychological risks have not been acknowledged. This study aims to investigate emotional and behavioral problems in pre-school children born with elective CS (ECS) on maternal request prior to 39 weeks. Methods Pregnant women within 12 gestational weeks between November 2008 and October 2010 were invited to participate in the China-Anhui Birth Cohort Study (C-ABCS). They were asked to complete a self-administered questionnaire respectively in 1st and 3rd trimester of pregnancy to collect basic maternal characteristics. Pregnant complications and delivery modes were abstracted from medical notes. Their singleton live births were followed up at preschool age. Strengths and Difficulties Questionnaires (SDQ) were completed by parents to assess children’s emotional and behavioral problems. A total of 3319 mother-child pairs were put into the final analysis. Descriptive analysis and binary logistic regression analysis were used to assess the impact of delivery modes on abnormalities in SDQ dimensions at various gestational ages. Results The prevalence of ECS on maternal request prior to 39 weeks, at 39–40 weeks, and after 41 weeks was 16.6, 23.7 and 15.9%, respectively. Compared with those born vaginally, children born with ECS on maternal request were more likely to have total difficult problems (RR 1.519, 95% confidence interval 1.077 to 2.142). ECS on maternal request was the independent predictor of emotional problems (3.479, 1.676 to 7.222) and total difficult problems (2.172, 1.175 to 4.016) in children born prior to 39 gestational weeks. Conclusion Children delivered by ECS on maternal request have an increased risk to have emotional and behavioral problems prior to 39 gestational weeks at preschool age. The potential psychological implication prior to 39 weeks has been added to the roster of impacts of ECS on maternal request. Further research is needed to probe the potential biological mechanisms.

Background: The recent increase in early term birth rates represents a growing challenge to public health given the association between early term birth and neonatal morbidities. We compared the risk of respiratory morbidity between early term and full‐term infants. Methods: This retrospective cohort population study included infants born at 37–41 weeks' gestation in a single tertiary care university hospital between 2014 and 2016. Newborns were categorized as early term (37–38 weeks) and full term (39–41 weeks). The primary outcome was respiratory morbidity. Results: Of the 4,894 babies born at 37–41 weeks gestational age, 31% (n = 1,521) were early term births. The rate of cesarean deliveries, which were often elective, was higher for early term than for full‐term newborns (P = 0.001). Compared with full‐term newborns, early term newborns, had significantly higher risks of respiratory morbidity (13.2 % vs 6.3 %; odds ratio [OR], 2.28, P = 0.001), respiratory distress syndrome (0.5 % vs 0 %, P = 0.001), transient tachypnea of the newborn (11.2 % vs 4.6 %; OR, 2.72, P = 0.001), continuous positive airway pressure use (9.7 % vs 3.7 %; OR, 2.82, P = 0.001), and ventilation support (1.4% vs 0.4%; OR, 4.11, P = 0.001). Conclusions: The elevated frequency of respiratory morbidity in early term infants emphasizes the importance of early term birth interventions. More than half of the early term births were elective cesarean sections; interventions should therefore focus on reducing elective cesarean procedures at the time of first birth. [ABSTRACT FROM AUTHOR]

Background: Chorioamnionitis is a frequent complication of pregnancy and is known to be associated with serious adverse post-natal outcomes including death. However, the assessment of fetal well-being in labor in the context of chorioamnionitis is often challenging because of fetal tachycardia. Identifying specific risk factors for adverse neonatal outcomes in the context of chorioamnionitis could therefore be of paramount importance. This study aimed to determine if maternal and fetal risk factors for increased neonatal mortality and early neonatal mortality are modified in the context of chorioamnionitis in term pregnancies.Methods: A retrospective population-based cohort study using the United States birth/infant death public file from 2011 to 2013 was performed, including all live births at 37 weeks gestation and beyond. Interaction between chorioamnionitis and maternal demographic variables as well as labor and delivery potential risk factors were analyzed for association with neonatal death (< 28 days) and early neonatal death (< 7 days) using multivariate logistic regressions.Results: Among 9,034,428 live births, the prevalence of chorioamionitis was 1.29% (95% CI 1.28-1.30%). The incidence of neonatal death and early neonatal death were 0.09 and 0.06% in the chorioamnionitis group versus 0.06 and 0.04% in the no chorioamnionitis group (p = 0.0003 and < 0.0001), respectively. Smoking was significantly associated with neonatal death and early neonatal death in the context of chorioamnionitis (OR 2.44, CI:1.34-4.43/ 2.36 CI:1.11-5.01) but was either less strongly or not associated in the absence of chorioamnionitis (OR 1.24, CI:1.14-1.35/0.93, CI:0.82-1.05). The association between gestational age (37 weeks compared to 39 weeks) and neonatal death was more important in the context of chorioamnionitis (OR = 3.19, CI: 1.75-5.82 versus 1.63, CI: 1.49-1.79). Multivariate analysis identified the following risk factors for neonatal death and/or early neonatal death: low maternal education, extreme maternal age, obesity (BMI > 35 kg/m2), late or no prenatal care, diabetes, meconium-stained amniotic fluid, gestational ages other than 39 weeks, neonatal weight < 2500 g and delivery by vacuum or caesarian.Conclusions: Smoking as well as early term have a positive interaction with chorioamnionitis for the risk of neonatal mortality. This should be taken into account when counseling pregnant women and managing laboring pregnant women with suspected chorioamnionitis. [ABSTRACT FROM AUTHOR]

Background: Compared with vaginal delivery, early-term cesarean section (CS) is associated with an increased risk of neonatal respiratory morbidity. Given the role of steroids in lung maturation in preterm labor, few studies have investigated their effects on early-term delivery. Therefore, this study aimed to investigate the effect of antenatal betamethasone on neonatal respiratory morbidity in early-term elective cesarean (37-38 weeks and 6 d).Methods: This randomized clinical trial was conducted in Mahdieh Hospital in Tehran in 2017. Women with single pregnancy who were candidates for planned elective CS in 37-38 weeks and 6 d of gestation were randomly assigned to either betamethasone group (intramuscular injection of 12 mg of betamethasone in two doses with an interval of 24 h from the 37th week of gestation) or control group (routine treatment). Then, neonatal respiratory morbidities, hospitalization in NICU, and its cause and duration were recorded and compared between the two groups.Results: Of all, 16 neonates (7%) suffered from one or more respiratory morbidities, and there was no significant difference between the betamethasone and control groups (six cases (6%) and 10 cases (9%), respectively, p = .299). There was also no significant difference between betamethasone and control groups in terms of the frequency of respiratory morbidities at the gestational age of 37 and 38 weeks (p > .05). Grunting, retraction, or nasal flaring was the most common respiratory morbidity that was observed in 13 neonates (6%). We observed the need for CPAP in three neonates (1%), respiratory distress syndrome (RDS) in three neonates (1%), transient tachypnea of the newborn (TTN) in two neonates (1%), need for resuscitation at birth in one neonate (0.5%), and apnea in one neonate (0.5%). There was no significant difference between the two groups in terms of respiratory morbidities (p > .05). A total of 17 neonates (8%) were admitted to NICU; the number of neonates admitted to NICU was significantly lower in betamethasone group than in the control group (three neonates (7.2%) and 14 neonates (12.7%), respectively, p = .005). Respiratory distress in 11 neonates (5%), sepsis in two neonates (1%), and other cases in four neonates (2%) were the main reasons for NICU admission. The prevalence of respiratory distress, as a cause for admission, was significantly lower in the betamethasone group (p = .005).Conclusion: The findings of this study showed that intramuscular injection of 12 mg of betamethasone in two doses, with an interval of 24 h, after 37 weeks of gestation in women undergoing early-term CS did not have a significant effect on respiratory morbidities in neonates. However, it decreased the frequency of admission to NICU, especially admission due to respiratory distress; it could indicate that the respiratory morbidities were less severe in betamethasone group than in the control group. [ABSTRACT FROM AUTHOR]

Extreme prematurity is known as a risk factor for autism spectrum disorder (ASD). However, the association between prematurity and ASD, for children born moderately and late preterm (MLPT) and those born early term (ET), is less established. This retrospective study aimed to characterize the phenotypic characteristics (i.e. behavioral profile and cognitive abilities) of 254 children with ASD, between 3 and 15 years of age, born MLPT (19 children), ET (60 children) and full term (175 children). MLPT and ET births do not modify ASD symptomatology, but modify cognitive development. The results highlight that incomplete gestation, i.e., MLPT or ET, has a negative impact on both verbal and nonverbal cognitive abilities, in children with neurodevelopmental vulnerability. [ABSTRACT FROM AUTHOR]

Objective: Higher rates of adverse outcomes have been reported for early term (37 0 to 38 6 weeks) versus full term (≥ 39 0 weeks) infants, but differences in breastfeeding outcomes have not been systematically evaluated. This study examined breastfeeding initiation and exclusivity in early and full term infants in a large US based sample. Methods: This secondary analysis included 743 geographically- and racially-diverse women from the Measurement of Maternal Stress Study cohort, and 295 women from a quality assessment at a hospital-based clinic in Evanston, IL. Only subjects delivering ≥ 37 weeks were included. Initiation of breastfeeding (IBF) and exclusive breastfeeding (EBF) were assessed via electronic medical record review after discharge. Associations of IBF and EBF with early and full term delivery were assessed via univariate and multivariate logistic regression. Results: Among 872 women eligible for inclusion, 85.7% IBF and 44.0% EBF. Early term delivery was not associated with any difference in frequency of IBF (p = 0.43), but was associated with significantly lower odds of EBF (unadjusted OR 0.61, 95% CI 0.466, 0.803, p < 0.001). This association remained significant (adjusted OR 0.694, 95% CI 0.515, 0.935, p = 0.016) after adjusting for maternal diabetes, hypertensive disorders of pregnancy, cesarean delivery, maternal age, race/ethnicity, parity, Medicaid status, NICU admission, current smoking, and delivery hospital. Conclusions for Practice: Despite comparable breastfeeding initiation frequencies, early term infants were significantly less likely to be exclusively breastfed compared to full term infants. These data suggest that women with early term infants may benefit from counseling regarding the potential for breastfeeding difficulties as well as additional breastfeeding support after delivery. [ABSTRACT FROM AUTHOR]

Introduction: Recent recommendations characterize deliveries at 37+0  weeks through 38+6  weeks as early term. We aimed to review the literature systematically on long-term cognition, school performance and behavior in children born early term (37+0 to 38+6 weeks) compared with full term (39+0  to 40+6 weeks).Material and Methods: The review was performed according to the PRISMA Statement. The final literature search was performed on 31 January 2019. We located studies in PubMed, Embase, CINAHL and Cochrane Library. Eligible studies were randomized controlled trials, cohort studies and case-control studies, with outcome assessment performed at 2-19 years. We collected information using a structured data form and evaluated study quality using the Newcastle-Ottawa Scale (NOS).Results: We included 42 observational studies published between 2006 and 2018. No restriction on year of publication was made. The mean NOS score was 5.8 with a range from 3 to 9. Compared with children born full term, children born early term had a lower intelligence score in early adulthood and up to some 30% increased risk of attention-deficit/hyperactivity disorder. Furthermore, we found some 10%-40% increased risk of cognitive problems, some 25% higher risk of language impairments and another 8%-75% with poorer overall school performance. No meta-analysis was conducted due to heterogeneity in the outcome measures. Only 10 studies presented subgroup analyses in spontaneous deliveries or adjusted for type of labor onset/induction.Conclusions: Children born early term are at increased risk of cognitive deficits, poorer school performance and behavioral problems compared with children born full term. [ABSTRACT FROM AUTHOR]

Late preterm (LP) and early term (ET) infants can be considered the "great dissemblers": they resemble healthy full-term infants in appearance, but their immaturity places them at increased risk of poor short- and long-term outcomes. Nutritional requirements are greater than for full-term babies, but there are few good data on the nutritional requirements for LP and ET babies, leading to substantial variation in practice. Recent data indicate that rapid growth may be beneficial for neurocognitive function but not for body composition and later metabolic health. Breastfeeding the LP or ET infant can be challenging, and mothers of these infants may need additional support to breastfeed successfully. Future research should investigate nutritional requirements of LP and ET infants for optimal growth, addressing both short- and long-term outcomes and the potential trade-off between neurocognitive and metabolic benefits. [ABSTRACT FROM AUTHOR]

Despite an increasing body of knowledge on the adverse clinical sequelae associated with late preterm birth and early term birth, little is known about their economic consequences or the cost-effectiveness of interventions aimed at their prevention or alleviation of their effects. This review assesses the health economic evidence surrounding late preterm and early term birth. Evidence is gathered on hospital resource use associated with late preterm and early term birth, economic costs associated with late preterm and early term birth, and economic evaluations of prevention and treatment strategies. The article highlights the limited perspective and time horizon of most studies of economic costs in this area; the limited evidence surrounding health economic aspects of early term birth; the gaps in current knowledge; and it discusses directions for future research in this area, including the need for validated tools for measuring preference-based health-related quality-of-life outcomes in infants that will aid cost-effectiveness-based decision-making. [ABSTRACT FROM AUTHOR]

Respiratory distress in late-preterm and early term infants generally may warrant admission to a special care nursery or an intensive care unit. In particular, respiratory distress syndrome and transient tachypnea of the newborn are the two most common respiratory morbidities. Antenatal corticosteroids (ACS) facilitate surfactant production and lung fluid resorption. The use of ACS has been proven to be beneficial for preterm infants delivered at less than 34 weeks’ gestation. Literature suggests that the benefits of giving antenatal corticosteroids may extend to late-preterm and early term infants as well. This review discusses the short-term benefits of ACS administration in reducing respiratory morbidities, in addition to potential long term adverse effects. An update on the current practices of ACS use in pregnancies greater than 34 weeks’ gestation and considerations of possibly extending versus restricting this practice to certain settings will also be provided.

Abstract Background Approximately 5–10 % of newborns require some form of resuscitationupon delivery; several factors, such as maternal abnormal conditions, gestational age and type of delivery could be responsible for this trend. This study aimed to describe the factors associated with the need for positive pressure ventilation (PPV) via a mask or endotracheal tube and the use of supplemental O2 in newborns with a gestational age greater than 34 weeks in Brazil. Methods We performed a cross-sectional study and obtained data from the Birth in Brazil Survey. The inclusion criterion was a gestational age ≥34 weeks. Exclusion criteria were newborns with congenital malformations, and cases with undetermined gestational age or type of delivery (vaginal, pre labor cesarean section and cesarean section during labor). The primary outcomes were need of PPV via a mask or endotracheal tube and the use of supplemental oxygen without PPV. Confounding variables, including maternal age, source of birth payment, years of maternal schooling, previous birth, newborn presentation, multiple pregnancy, and maternal obstetric risk, were analyzed. Results We included 22,720 newborns. Of these, 2974 (13.1 %) required supplementary oxygen. PPV with a bag and mask was used for 727 (3.2 %) newborns and tracheal intubation for 192 (0.8 %) newborns. Chest compression was necessary for 136 (0.6 %) newborns and drugs administered in 114 (0.5 %). 51.3 % of newborns were delivered by cesarean section, with the majority of cesarean sections (88.7 %) being performed prior to labor. Gestational age (late preterm infants: (Relative Risk-(RR) 2.46; 95 % (Confidence interval-CI 1.79–3.39), maternal obstetric risk (RR 1.59; 95 % CI1.30–1.94), and maternal age of 12–19 years old (RR 1.36; 95 % CI1.06–1.74) contributed to rates of PPV in the logistic regression analysis. Newborns aged between 37–38 weeks of gestaional age weren´t less likely to require PPV compared with those aged 39–41 weeks of gestational age. Conclusions Late preterm infants, previous maternal obstetric risks and maternal age contributed to the higher needs of PPV and use of O2 in the delivery room. These variables need to be considered in planning care in the delivery room.

Abstract Background Emerging evidence indicates that infants who were born between 37 and 38 weeks of gestation are at higher risk of adverse long-term neurodevelopmental outcomes. Yet little is known about the auditory neural maturation during the first year of their life. Aim To compare the development of auditory brainstem response in early term (ET, 37–38 weeks gestational age, GA) and full term (FT, 39–41 weeks GA) infants. Methods 126 infants received ABR testing at 6 weeks. 107 of them returned for the second assessment at 9 months, among which, 93 completed the ABR recordings. Comparison of the ABR variables were made depending on gestational age. Results Analysis of covariance (ANCOVA) was used to identify the differences in ABR outcomes between two groups. After controlling for confounders, latencies for wave III, V and I-III, III-V and I-V intervals were prolonged in ET group compared with FT group at 6 weeks (all p <0.03). ABR parameters of both groups developed as the infants got older. At 9 months, ET infants remain showing the longer wave V latency and I-V interval (all p < 0.02) than FT infants. Conclusion During early postnatal life, ET has a different pattern of functional auditory brainstem development comparing with FT infants. The prolonged auditory conduction time suggests less mature of the central auditory system in ET infants before 9 months. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To examine the predictive value of ultrasound parameters for antepartum non‐reassuring fetal status (NRFS) in fetal growth restriction (FGR) cases after late preterm. Methods: Retrospective review of singleton FGR cases before 37 weeks gestation who delivered after 34 weeks gestation was performed. The association between ultrasound parameters that was assessed from 34 to 36 weeks gestation and the development of antepartum NRFS that was diagnosed by nonstress test and biophysical profile was analyzed by using multivariate Cox proportional hazards analyses. Results: A total of 214 patients were included in final data analyses. Antepartum NRFS occurred in 23 cases (10.7%) including five cases of placental abruption. Lower standard deviation (SD) of estimated fetal weight (EFW), lower cerebroplacental ratio (CPR) and the presence of oligohydramnios were independently associated with antepartum NRFS. The prevalence of antepartum NRFS was highest (50.4%) in the group of EFW ≤−2.5 SD with CPR ≤1.45. Conclusion: Ultrasound parameters of lower SD of EFW, lower CPR and oligohydramnios were predictive for antepartum NRFS in FGR after late preterm. [ABSTRACT FROM AUTHOR]

Purpose: (1) Compare fetal and neonatal morbidity and mortality associated with induction of labor (IOL) versus expectant management (EM) in women with isolated fetal growth restriction (FGR) between 340/7 and 386/7 weeks; (2) Determine optimal gestational age for delivery of such fetuses.Materials and Methods: A retrospective population based cohort study of 2232 parturients with isolated FGR, including two groups: (1) IOL (n = 1428); 2) EM (n = 804).Results: IOL group had a lower stillbirth and neonatal death rates (p = .042, p < .001), higher 1 and 5 min Apgar scores and a higher vaginal delivery rate compared to the EM group. In the late preterm period, EM was associated with increased rate of low 1 and 5 min Apgar scores, nonreassuring fetal heart rate tracing (NRFHR), stillbirth and neonatal death rate (p = .001, p = .039). In the early term cohort, EM was associated with a higher rate of NRFHR and low 1 min Apgar scores (p = .003, p = .002). IOL at 37 weeks protected from stillbirth but not from adverse composite neonatal outcomes.Conclusions: IOL of FGR fetuses at 37 weeks had a protective effect against stillbirth. In addition, at late preterm, it is associated with lower rates of stillbirth, neonatal death, and NRFHR. [ABSTRACT FROM AUTHOR]

Background: Cesarean section deliveries at 37 weeks gestational period are incredibly high in Turkey. In order to determine the antenatal characteristics, respiratory morbidity and mortality cases, we have conducted a retrospective cohort study on this population. Methods: 514 infants encountering clinical signs of respiratory distress within 24 hours were enrolled. To compare the differences, infants were categorized into three groups as: late-preterm, early-term and full-term infants. Demographic and clinical data were explored. Results: Early-term infants represented higher RDS rates (13.1%; P = 0.033 for early-term and full-term infants; P = 0.338 for early-term and late-preterm infants), meconium aspiration syndrome (P < 0.001 for early-term and late-preterm infants; P < 0.001 for early-term and full-term infants) and lower Apgar scores at 5 minutes (6.1±1.98; P< 0.001 for early-term and full-term infants; P = 0.642 for early-term and late-preterm infants). They necessitated conventional mechanical ventilation more often compared to late-preterm and full-term neonates (39.3%; P = 0.050, P = 0.042); however late-preterm infants represented longer intubation periods (P = 0.014, P < 0.001) and intensive care stays (P < 0.001; P < 0.001). Conclusions: Early-term neonates encounter respiratory problems, morbidities and significant respiratory distress syndrome rates similar to the rates of late preterm neonates and seemed to have a tendency to hypoxic deliveries with low Apgar scores. Considering the increasing delivery rate at this period, real estimates should be investigated in large, multi-centered prospective studies in terms of both short and long term outcomes. [ABSTRACT FROM AUTHOR]