A prospective observational study on pattern of early term neonatal morbidities
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 9, Pages 3234-3241
AbstractAim: The aim of this study to evaluate the early neonatal morbidities in early term neonates.
Materials and Methods: This prospective, observational study was done the Department of Paediatrics, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. For 16 months. consecutive 320 intramural newborns were examined and all the early term (37 [0/7] to 38[6/7] weeks) and the full-term (39[0/7] to 41[6/7] weeks) babies were include for the study. Morbidities of the early term and full-term babies within the first seven days of life were observed. All the babies included in the study were examined at birth, after 24 hours, after 48 hours and daily up to seven days.
Results: Consecutive 320 live births were included in the study during the study period. Out of the total 320 population included in the study, 120 were early term (37.5%) and 200 were full terms (62.5%). Among the study population most of the babies were 39 weeks of gestational age and the least being 37 weeks. The mean gestational age of the population was 39.44 ± 1.42 weeks. Among the total population 95 were delivered by cesarean section (29.69%) and 225 had vaginal (70.31%) birth (table 3). Among the early term deliveries 39 were delivered by cesarean section (32.5%) and 81 by vaginal delivery (67.5%). Out of total full tem deliveries 56 were by cesarean section (28%) and 144 by vaginal delivery (72%). P-value is 0.784. NICU/SNCU admission rates were higher for babies born at an earlier gestational age (14.67% v/s 9%) than babies born later. Incidence of morbidities like jaundice requiring phototherapy (5% v/s 2%), need for resuscitation (6.67% v/s4 %), hypoglycemia on admission (5% v/s 2%), respiratory morbidities (3.33% v/s 2%), need for mechanical ventilation (1.67% v/s 0.5%),clinical sepsis (6.67% v/s 3.5%), confirmed sepsis (5% v/s 1.5%), need for intravenous antibiotics (10.83% v/s 6.5%), need for intravenous fluid (12.5% v/s 7%) were significantly higher in early terms than full terms during the first one week of life. Significantly higher number of babies delivered by cesarean section needed intervention and NICU admission (15.79% v/s 8.44%) than vaginally born babies. Moreover, among the cesarean deliveries the early term babies had significantly more morbidities or NICU/SNCU admission than their counterparts.
Conclusion: Neonatal morbidity decreases with delivery at later gestational ages and that infants delivered at 37 and 38 weeks’ gestation, are at increased risk for morbidity compared to infants delivered at 39 weeks or later. So, to reduce early term deliveries and its influence on health care system we should carefully consider the optimal timing and route of delivery
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