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Mortality and morbidity in late preterm newborns

Year 2013, Volume: 48 Issue: 1, 17 - 22, 01.03.2013

Abstract

Aim: There has been a gradual rise in late preterm infant rates in recent years Although the late preterm infants have a lower risk compared to smaller preterms some recent studies have suggested an incresed risk of mortality and morbidiy in this group compared to term infants The aim of this study was to determine the rate of late preterm births in our hospital detect the neonatal mortality and morbidity of late preterm newborns and compare the results with term newborns Material and Method: For this prospective study the gestational age of all infants born alive in our hospital between May 1 2009 May 1 2010 were assessed using the mother rsquo;s last menstrual period and the new Ballard test Our study group consisted of 220 infants selected among infants born late preterm 34 0 7 36 6 7 weeks while 200 term newborns constituted our control group Newborns with major congenital abnormalities and whose families did not consent were excluded The subjects were seen and evaluated at 72 hours and weekly for one month Results: During the study period 412 of 2582 15 2 babies born in our hospital were late preterms The number and rate of neonatal ICU admissions of term and late preterm infants were 28 14 and 172 54 5 respectively Respiratory problems in late preterms were significantly more frequent 31 8 versus 2 Mechanical ventilation was used in 20 9 of late preterms while no term newborns needed it Late preterms overall were more likely to have feeding problems 19 1 vs 0 5 hyperbilirubinemia 44 1 vs 7 5 hypoglicemia 6 4 vs 1 0 hypotermia 14 5 vs 0 and infection 15 9 vs 0 The mortality rate in late preterm infants were 1 times more than term infants 5 5 vs 0 5 Conclusions: Late preterms have a significantly higher risk of morbidity and mortality compared to term newborns They should be monitored closely interms of a higher risk of morbidity and a higher risk of admittion to hospital Turk Arch Ped 2013; 48: 17 22

References

  • McLaurin KK, Hall CB, Jackson EA, Owens OV, Mahadevia PJ. Persistence of morbidity and cost differences between late-preterm and term infants during the first year of life. Pediatrics 2009; 123: 653-9.
  • Davidoff MJ, Dias T, Damus K, et al. Changes in the gestational age distrubition among US singleton births: impacts on rates of late preterm births, 1992 to 2002. Semin Perinatol 2006; 30: 8-15.
  • Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, et al. Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk. Pediatrics 2008; 121: e223-232.
  • Khashu M, Narayanan M, Bhargava S, Osiovich H. Perinatal outcomes associated with preterm birth at 33 to 36 weeks’ gestation: a population-based cohort study. Pediatrics 2009; 123: 109-13.
  • Engle WA, Tomashek KM, Wallman C; Committee on Fetus and Newborn, American Academy of Pediatrics. ”Late-preterm” infants: a population at risk. Pediatrics 2007; 120:1390-401.
  • Raju TN, Higgins RD, Stark AR, Leveno KJ. Optimising care and outcome for late preterm infants: a summary of the workshop sponsored by the national institute of child health and human development. Pediatrics 2006; 118: 1207-14.
  • Escobar GJ, Clark RH, Greene JD. Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions. Semin Perinatol 2006; 30: 28-33.
  • Rawlings JS, Smith FR. Transient tachypnea of the newborn: An analysis of neonatal and obstetric risk factors. Am J Dis Child 1984; 138: 869-71.
  • Abu-Shaweesh JM. Respiratory disorders in preterm and term infants. In: Martin RJ, Fanaroff AA, Walsh MC, (eds). Fanaroff &Martin’s neonatal-perinatal medicine. Diseases of the fetus and infant. St. Louis: Elsevier Mosby, 2011: 1141- 206.
  • American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004; 114: 297-316. Maisels MJ. The clinical approach to the jaundiced newborn. In: Maisels MJ, Watchko JF, (eds). Neonatal jaundice. Amsterdam: Harwood Academic, 2000: 139-68.
  • Edwards MS. Postnatal bacterial infections. In: Martin RJ, Fanaroff AA, Walsh MC, (eds). Fanaroff &Martin’s neonatal-perinatal medicine. Diseases of the fetus and infant. St. Louis: Elsevier Mosby, 2011: 793-830.
  • Çoban A. Yenidoğanda metabolik sorunlar. İçinde: Neyzi O, Ertuğrul T, (yazarlar). Pediyatri. İstanbul: Nobel Matbaacılık, 2010: 453-66.
  • Consortium on Safe Labor, Hibbard JU, Wilkins I, et al. Respiratory morbidity in late preterm births. JAMA 2010; 304: 419- 25.
  • McIntire D, Leveno KJ. Neonatal mortality and morbidity rates in late preterm births compared with births at term. Obstet Gynecol 2008; 111: 35-41.
  • Osrin D. The implications of late-preterm birth for global child survival. Int J Epidemiol 2010; 39: 645-9.
  • Laughon SK, Reddy UM, Sun L, Zhang J. Precursors for late preterm birth in singleton gestations. Obstet Gynecol 2010; 116: 1047-55.
  • Ortigosa Rocha CO, Bittar RE, Zugaib M. Neonatal outcomes of latepreterm birth associated or not with intrauterine growth restriction. Obstet and Gynecol Int 2010: 231842.
  • Martin JA, Kung HJ, Mathews TJ, et al. Annual summary of vital statistics: 2006. Pediatrics 2008; 121: 788-801.
  • Tomashek KM, Shapiro-Mendoza CK, Davidoff MJ, Petrini JR. Differences in mortality between late-preterm and term singleton infants in the United States, 1995- 2002. J Pediatr 2007; 151: 450-6. Wang ML, Dorer DJ, Fleming MP, Catlin EA. Clinical outcomes of nearterm infants. Pediatrics 2004; 114: 372-6.
  • McLaurin KK, Hall CB, Jackson EA, Owens OV, Mahadevia PJ. Persistence of morbidity and cost differences between late preterm and term infants during the first year of life. Pediatrics 2009; 123: 653-9.
  • Loftin RW, Habli M, Snyder CC, Cormier CM, Lewis DF, Defranco EA. Late preterm birth. Rev Obstet Gynecol 2010; 3:10-9.
  • Kramer MS, Demisse K, Yang H, Platt RW, Sauvé R, Liston R. The contribution of mild and moderate preterm birth to infant mortality. JAMA 2000; 284: 843-9.
  • Pulver LS, Warnick GG, Stoddard GJ, Byington CL, Young PJ. Weigh for gestational age affects the mortality of late preterm infants. Pediatrics 2009; 123: e1072-7.
  • Kalyoncu Ö, Aygün C, Çetinoğlu E, Küçüködük Ş. Neonatal morbidity and mortality of late-preterm babies. J Maternal-Fetal and Neonatal Med 2010; 23: 607-12.
  • Committee on Fetus and Newborn, Adamkin DH. Clinical reportpostnatal glucose homeostasis in late-preterm and term infants. Pediatrics 2011; 127: 575-9.
  • Picone S, Paolillo P. Neonatal outcomes in population of late-preterm infants. J Matern Fetal Neonatal Med 2010; 13: 116-20.

Geç preterm yenidoğanlarda hastalık ve ölüm oranları

Year 2013, Volume: 48 Issue: 1, 17 - 22, 01.03.2013

Abstract

Amaç: Son yıllarda geç preterm bebeklerde kademeli bir artış sözkonusudur. Geç pretermler daha küçük erken doğmuş bebeklere göre daha az riskli olmalarına rağmen son çalışmalar bu bebeklerin zamanında doğmuş bebeklere göre daha fazla hastalık ve ölüm oranına sahip olduklarını düşündürmektedir. Bu çalışmada hastanemizdeki tüm doğumlar içindeki geç preterm doğum oranını belirlemek, bu bebeklerin yenidoğan hastalık ve ölüm oranını saptamak ve sonuçlarını zamanında doğmuş yenidoğanlarla karşılaştırmak amaçlandı.

Gereç ve Yöntem: İleriye dönük olarak planlanan bu çalışma için hastanemiz Kadın Doğum Kliniği’nde 1 Mayıs 2009-1 Mayıs 2010 tarihleri arasında canlı doğan tüm bebeklerin gestasyonel yaşları annenin son adet tarihi ve yeni Ballard testi kullanılarak değerlendirildi. Geç prematüre (34 0/7-36 6/7 gestasyon haftasında) doğan bebekler arasından seçilen 220 bebek çalışma grubumuzu, aynı tarihlerde doğan 200 zamanında doğmuş bebek ise kontrol grubumuzu oluşturdu. Olgular 72. saatte, ve haftalık kontrollerle bir aylık olana kadar izlendi. Büyük ölçüde anomalili bebekler, ailesi onam vermeyenler çalışmaya dahil edilmediler. Hastalar Yenidoğan Yoğun Bakım Birimi’nde yatış, hipotermi, solunum sorunları, metabolik sorunlar, polistemi, enfeksiyon, apne, konvülziyon açısından değerlendirildi. Çalışmada elde edilen bulguların istatistiksel analizleri NCSS 2007 programı ile yapıldı. Sonuçlar, anlamlılık p<0,05 düzeyinde, %95’lik güven aralığında değerlendirildi. Çalışma için etik kurul onayı alındı (no:44/ 04.05.2009).

Bulgular: Çalışma süresinde hastanemizde doğan 2 582 bebeğin 412’si (%15,2) geç preterm idi. Yenidoğan Yoğun Bakım Birimi’ne yatış sayı ve oranları , zamanında doğmuş bebeklerde ve geç pretermlerde sırasıyla 28 (%14) ve 172 (%54,5) bulundu. Geç pretermlerde zamanında doğmuş yenidoğanlara göre solunum sorunu anlamlı olarak daha sık görüldü (%31,8’e karşı %2). Geç pretermlerin %20,9’unda mekanik ventilasyon gereksinimi saptandı; zamanında doğmuş yenidoğanlarda mekanik ventilasyon gereksinimi olmadı. Geç pretermlerde zamanında doğmuş yenidoğanlarla karşılaştırıldığında daha fazla beslenme sorunları (%19,1’e karşı %0,5), tedavi gerektiren sarılık (%44,1’e karşı %7,5), hipoglisemi (%6,4’e karşı %1), hipotermi (% 0’a karşı %14,5), ve enfeksiyon (%15,9 karşı %0) saptandı. Ölüm oranı geç preterm bebeklerde (%5,5) zamanında doğmuş bebeklere (%0,5) göre 11 kat daha fazla bulundu.

Çıkarımlar: Geç preterm yenidoğanlar zamanında doğanlara göre anlamlı olarak daha yüksek hastalık ve ölüm oranına sahiptirler. Geç preterm yenidoğanlar, sık görülen hastalıklar ve hastaneye yatış riski açısından yakın izleme alınmalıdırlar.

References

  • McLaurin KK, Hall CB, Jackson EA, Owens OV, Mahadevia PJ. Persistence of morbidity and cost differences between late-preterm and term infants during the first year of life. Pediatrics 2009; 123: 653-9.
  • Davidoff MJ, Dias T, Damus K, et al. Changes in the gestational age distrubition among US singleton births: impacts on rates of late preterm births, 1992 to 2002. Semin Perinatol 2006; 30: 8-15.
  • Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, et al. Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk. Pediatrics 2008; 121: e223-232.
  • Khashu M, Narayanan M, Bhargava S, Osiovich H. Perinatal outcomes associated with preterm birth at 33 to 36 weeks’ gestation: a population-based cohort study. Pediatrics 2009; 123: 109-13.
  • Engle WA, Tomashek KM, Wallman C; Committee on Fetus and Newborn, American Academy of Pediatrics. ”Late-preterm” infants: a population at risk. Pediatrics 2007; 120:1390-401.
  • Raju TN, Higgins RD, Stark AR, Leveno KJ. Optimising care and outcome for late preterm infants: a summary of the workshop sponsored by the national institute of child health and human development. Pediatrics 2006; 118: 1207-14.
  • Escobar GJ, Clark RH, Greene JD. Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions. Semin Perinatol 2006; 30: 28-33.
  • Rawlings JS, Smith FR. Transient tachypnea of the newborn: An analysis of neonatal and obstetric risk factors. Am J Dis Child 1984; 138: 869-71.
  • Abu-Shaweesh JM. Respiratory disorders in preterm and term infants. In: Martin RJ, Fanaroff AA, Walsh MC, (eds). Fanaroff &Martin’s neonatal-perinatal medicine. Diseases of the fetus and infant. St. Louis: Elsevier Mosby, 2011: 1141- 206.
  • American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004; 114: 297-316. Maisels MJ. The clinical approach to the jaundiced newborn. In: Maisels MJ, Watchko JF, (eds). Neonatal jaundice. Amsterdam: Harwood Academic, 2000: 139-68.
  • Edwards MS. Postnatal bacterial infections. In: Martin RJ, Fanaroff AA, Walsh MC, (eds). Fanaroff &Martin’s neonatal-perinatal medicine. Diseases of the fetus and infant. St. Louis: Elsevier Mosby, 2011: 793-830.
  • Çoban A. Yenidoğanda metabolik sorunlar. İçinde: Neyzi O, Ertuğrul T, (yazarlar). Pediyatri. İstanbul: Nobel Matbaacılık, 2010: 453-66.
  • Consortium on Safe Labor, Hibbard JU, Wilkins I, et al. Respiratory morbidity in late preterm births. JAMA 2010; 304: 419- 25.
  • McIntire D, Leveno KJ. Neonatal mortality and morbidity rates in late preterm births compared with births at term. Obstet Gynecol 2008; 111: 35-41.
  • Osrin D. The implications of late-preterm birth for global child survival. Int J Epidemiol 2010; 39: 645-9.
  • Laughon SK, Reddy UM, Sun L, Zhang J. Precursors for late preterm birth in singleton gestations. Obstet Gynecol 2010; 116: 1047-55.
  • Ortigosa Rocha CO, Bittar RE, Zugaib M. Neonatal outcomes of latepreterm birth associated or not with intrauterine growth restriction. Obstet and Gynecol Int 2010: 231842.
  • Martin JA, Kung HJ, Mathews TJ, et al. Annual summary of vital statistics: 2006. Pediatrics 2008; 121: 788-801.
  • Tomashek KM, Shapiro-Mendoza CK, Davidoff MJ, Petrini JR. Differences in mortality between late-preterm and term singleton infants in the United States, 1995- 2002. J Pediatr 2007; 151: 450-6. Wang ML, Dorer DJ, Fleming MP, Catlin EA. Clinical outcomes of nearterm infants. Pediatrics 2004; 114: 372-6.
  • McLaurin KK, Hall CB, Jackson EA, Owens OV, Mahadevia PJ. Persistence of morbidity and cost differences between late preterm and term infants during the first year of life. Pediatrics 2009; 123: 653-9.
  • Loftin RW, Habli M, Snyder CC, Cormier CM, Lewis DF, Defranco EA. Late preterm birth. Rev Obstet Gynecol 2010; 3:10-9.
  • Kramer MS, Demisse K, Yang H, Platt RW, Sauvé R, Liston R. The contribution of mild and moderate preterm birth to infant mortality. JAMA 2000; 284: 843-9.
  • Pulver LS, Warnick GG, Stoddard GJ, Byington CL, Young PJ. Weigh for gestational age affects the mortality of late preterm infants. Pediatrics 2009; 123: e1072-7.
  • Kalyoncu Ö, Aygün C, Çetinoğlu E, Küçüködük Ş. Neonatal morbidity and mortality of late-preterm babies. J Maternal-Fetal and Neonatal Med 2010; 23: 607-12.
  • Committee on Fetus and Newborn, Adamkin DH. Clinical reportpostnatal glucose homeostasis in late-preterm and term infants. Pediatrics 2011; 127: 575-9.
  • Picone S, Paolillo P. Neonatal outcomes in population of late-preterm infants. J Matern Fetal Neonatal Med 2010; 13: 116-20.
There are 26 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Research
Authors

Berrin Telatar This is me

Fatma Narter This is me

Pınar Binarbaşı This is me

Turgut Ağzıkuru This is me

Yasemin Akın This is me

Publication Date March 1, 2013
Published in Issue Year 2013 Volume: 48 Issue: 1

Cite

APA Telatar, B., Narter, F., Binarbaşı, P., Ağzıkuru, T., et al. (2013). Geç preterm yenidoğanlarda hastalık ve ölüm oranları. Türk Pediatri Arşivi, 48(1), 17-22.
AMA Telatar B, Narter F, Binarbaşı P, Ağzıkuru T, Akın Y. Geç preterm yenidoğanlarda hastalık ve ölüm oranları. Türk Pediatri Arşivi. March 2013;48(1):17-22.
Chicago Telatar, Berrin, Fatma Narter, Pınar Binarbaşı, Turgut Ağzıkuru, and Yasemin Akın. “Geç Preterm yenidoğanlarda hastalık Ve ölüm Oranları”. Türk Pediatri Arşivi 48, no. 1 (March 2013): 17-22.
EndNote Telatar B, Narter F, Binarbaşı P, Ağzıkuru T, Akın Y (March 1, 2013) Geç preterm yenidoğanlarda hastalık ve ölüm oranları. Türk Pediatri Arşivi 48 1 17–22.
IEEE B. Telatar, F. Narter, P. Binarbaşı, T. Ağzıkuru, and Y. Akın, “Geç preterm yenidoğanlarda hastalık ve ölüm oranları”, Türk Pediatri Arşivi, vol. 48, no. 1, pp. 17–22, 2013.
ISNAD Telatar, Berrin et al. “Geç Preterm yenidoğanlarda hastalık Ve ölüm Oranları”. Türk Pediatri Arşivi 48/1 (March 2013), 17-22.
JAMA Telatar B, Narter F, Binarbaşı P, Ağzıkuru T, Akın Y. Geç preterm yenidoğanlarda hastalık ve ölüm oranları. Türk Pediatri Arşivi. 2013;48:17–22.
MLA Telatar, Berrin et al. “Geç Preterm yenidoğanlarda hastalık Ve ölüm Oranları”. Türk Pediatri Arşivi, vol. 48, no. 1, 2013, pp. 17-22.
Vancouver Telatar B, Narter F, Binarbaşı P, Ağzıkuru T, Akın Y. Geç preterm yenidoğanlarda hastalık ve ölüm oranları. Türk Pediatri Arşivi. 2013;48(1):17-22.