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Neonatal and 5-year outcomes after birth at 30-34 weeks of gestation.
- Source :
-
Obstetrics and gynecology [Obstet Gynecol] 2007 Jul; Vol. 110 (1), pp. 72-80. - Publication Year :
- 2007
-
Abstract
- Objective: To evaluate the rates of in-hospital death, neonatal complications, and 5-year outcomes of infants born at 30-34 weeks of gestation.<br />Methods: In nine regions of France, all 2,020 stillbirths and live births at 30, 31, and 32 weeks in 1997 and all 457 births at 33 and 34 weeks in April and October 1997 were recorded. Survivors were evaluated at 5 years of age.<br />Results: Increasing gestational age from 30 to 34 weeks was associated with progressive decreases in in-hospital mortality (from 8.1% to 0.4%) and neonatal complications (respiratory distress syndrome, 43.8% to 2.6%; maternofetal infections, 7.2% to 2.6%; and severe white matter injury, 5.5% to 1.3%). Although infants at 33 and 34 weeks of gestation rarely experienced necrotizing enterocolitis, bronchopulmonary dysplasia, or nosocomial infections, they still required endotracheal ventilation, antibiotics, or parenteral nutrition. At 5 years of age, older gestational age was associated with significant decreases in rates of cerebral palsy (6.3% at 30 weeks and 0.7% at 34 weeks) and mild to severe cognitive impairments (35.3% at 30 weeks and 23.9% at 34 weeks). In singletons, preterm rupture of membranes or preterm labor carried an increased risk of cerebral palsy but not of cognitive impairment.<br />Conclusion: Neonates born at 30-34 weeks experienced substantial morbidity and often required admission to neonatal intensive care units. These outcomes suggest that prolonging pregnancies beyond 34 weeks may be desirable whenever possible. Infants born at 30-34 weeks should be carefully monitored to ensure prompt detection and management of neurodevelopmental impairment.
- Subjects :
- Child, Preschool
Cohort Studies
Female
Follow-Up Studies
France epidemiology
Humans
Incidence
Infant Mortality
Infant, Newborn
Intensive Care, Neonatal statistics & numerical data
Male
Patient Admission statistics & numerical data
Pregnancy
Pregnancy Trimester, Third
Retrospective Studies
Stillbirth epidemiology
Cerebral Palsy epidemiology
Cognition Disorders epidemiology
Gestational Age
Premature Birth
Subjects
Details
- Language :
- English
- ISSN :
- 0029-7844
- Volume :
- 110
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Obstetrics and gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 17601899
- Full Text :
- https://doi.org/10.1097/01.AOG.0000267498.95402.bd