Prevalence and neonatal outcomes of preterm born at Garissa county referral hospital, Kenya

Background: Despite the significance of late preterm and early term neonates in neonatal health, comprehensive data on their prevalence, morbidity, mortality, and associated maternal sociodemographic and economic characteristics is grossly lacking in Garissa County, Kenya. This study aimed to determine the prevalence, morbidity, and mortality of late preterm (LPN) and early term neonates (ETN) born at Garissa County Referral Hospital (GCRH), relative to full-term neonates (FTN). Methods: Singleton live neonates in the three groups were enrolled. Prevalence was computed as percentages of births in each category relative to total singleton live births during the study period. Ordinal logistic regression analysis was used to assess morbidity patterns, with statistical significance set at p<0.05. Mortality rates were presented as total deaths per 1,000 live births within the first 28 days. Results: The LPN, ETN, and FTN had a prevalence of 8.47%, 11.86%, and 9.2%, respectively. Maternal age was significantly associated with gestational age (p=0.014; ?c=0.263), while other sociodemographic and economic characteristics were comparable across groups (p>0.05). LPNs had lower odds of respiratory distress diagnosis on day 1 compared to ETNs (OR=-1.68896; 95% CI: -3.012335 to -0.365593; p=0.012). Mortality rates were comparable among gestational age categories (p=0.649). Conclusions: Overall, the study shows that LPN and ETN are considerably prevalent in Garissa County and that, only maternal age impacts on gestational age. Targeted interventions, particularly for younger mothers, should be implemented to mitigate associated risks and improve neonatal outcomes.

Timing of elective term deliveries and its association with adverse neonatal outcomes

Background: Pre and early term birth are one of the major causes of neonatal mortality and morbidity as compared to term infants. The risk of neonatal morbidity and mortality decreases with gestational age. Thus, this study aimed to determine the association of neonatal outcomes among early term and full-term elective deliveries. Methods: A prospective cohort study was conducted at the department of obstetrics and gynecology, Aga Khan University Hospital, Pakistan. A total of 390 women, 195 in each study group were selected using a non-probability consecutive sampling. Demographic was presented as simple descriptive statistics giving mean and standard-deviation. Pearson’s chi-square and Fisher-Freeman-Halton exact test were used to compare qualitative data. Risk-ratios (RR) and confidence-intervals (CI) were calculated by using binary logistic regression. STATA V.17 SE software was used for data analysis. Results: A total of 390 participants were recruited, including 195 patients in each group. The high prevalence of low Apgar score 5.6%, low birth weight 5.6% was found among early term when compared with full term. The respiratory distress was also reportedly high in early term neonates with 7.2%. Likewise, the prolonged hospital stays and NICU admissions were also more evident in early term elective deliveries i.e. 8.7% and 5.6%. Conclusions: Early-term births are associated with adverse neonatal outcome of low APGAR score, low birth weight, hospital stay, NICU admission and respiratory distress when compared with neonates born as full term through elective deliveries. Similarly, the risk of prolonged hospital stay a

Neuropsychological development of large for gestational age infants at the age of 12 months / 中国当代儿科杂志

OBJECTIVES@#To investigate the level of neuropsychological development in large for gestational age (LGA) infants at the age of 12 months.@*METHODS@#The infants, aged 12 to <13 months, who attended the Outpatient Service of Child Care in the First Affiliated Hospital of Shandong First Medical University from December 2021 to June 2023, were enrolled as subjects. According to the gestational age and birth weight, they were divided into preterm appropriate for gestational age (AGA) group, preterm LGA group, early term AGA group, early term LGA group, full-term AGA group, and full-term LGA group. A modified Poisson regression analysis was used to investigate the association between LGA and neuropsychological development outcome at 12 months of age.@*RESULTS@#After adjustment for confounding factors, compared with the full-term AGA group at the age of 12 months, the full-term LGA group had a significant increase in the risk of language deficit (RR=1.364, 95%CI: 1.063-1.750), the early term LGA group had significant increases in the risk of abnormal gross motor, fine motor, language, and the preterm LGA group had significant increases in the risk of abnormal language, social behavior, and total developmental quotient (P<0.05); also, the early term AGA group had higher risks of developmental delay across all five attributes and in total developmental quotient at the age of 12 months (P<0.05); except for the language attribute, the preterm AGA group had higher risks of developmental delay in the other 4 attributes (P<0.05).@*CONCLUSIONS@#The neuropsychological development of LGA infants with different gestational ages lags behind that of full-term AGA infants at 12 months of age, and follow-up and early intervention of such infants should be taken seriously in clinical practice.

Neonatal morbidity pattern in early term births

Background: Late preterm births are defined' as birth between 34 and 36 completed weeks gestation and term births as' born after 37 weeks of gestation. Maturation is a continuous' process till term and the severity of adverse outcomes with birth increases with decreasing gestational age. Recent studies showed increased risk of' morbidities for babies' at 37 weeks than its term counterpart babies' at 39 weeks. Considering the risk for adverse neonatal outcomes in early term births, various studies recommended that the label 'term' be redefined as early term, full term and late term designations to more accurately acknowledge deliveries occurring at or beyond 37' weeks of gestation. This designation will help precise' identification and targeting these early term' babies for early intervention and for better neonatal outcomes.Methods: This is a prospective study which included all' term births delivered during the 12-month study between January 2017 and December 2017. Babies born between 37 and 38 6/7 weeks were designated as early term and those born after 39 weeks as full-term babies. Neonatal outcomes of these babies were recorded and monitored till discharge.Results: There were 660 term live births during the study period. The incidence of early term births account for 19.7%, as compared with full term births representing 80.3 %. Compared with term babies, early term births were at risk for transitional problems such as respiratory distress (61.5% vs 38.5%), hypoglycemia (76.2% vs 23.8%), hyperbilirubinemia requiring phototherapy (53.7% vs 46.7%) and feeding' problems (59.1% vs 40.9%).Conclusions: Early term births are associated with increased risk of neonatal morbidities as compared with full term births. This indicates need for more attention towards preventing early term births.

Morbimortalidad del recién nacido a término precoz en el hospital Hipólito Unanue de Tacna durante los años 2000 a 2014 / Morbimortality of early term newborns at Tacna's Hipólito Unanue hospital during the years 2000 to 2014

Objetivo: Determinar la frecuencia, tasa de cesárea y riesgos de morbimortalidad del recién nacido a término precoz (RNTP). Material y métodos: Estudio observacional, retrospectivo, analítico. Se incluyó a neonatos únicos vivos a término, nacidos en el hospital Hipólito Unanue de Tacna durante los años 2000 a 2014 (n=45332). Se comparó a los nacidos a termino precoz de 37 a 38 6/7 semanas (n=11276), y los nacidos a termino completo de 39 a 41 6/7 semanas (n=34056). Se utilizó frecuencia y tasa por 100 nacidos vivos, odds ratio (OR) con intervalos de confianza al 95% (IC 95%), regresión logarítmica y prueba "t" para muestras independientes. Se utilizó la base de datos del Sistema Informático Perinatal. Resultados: La frecuencia de nacidos a término precoz fue 22,5 por 100 nacidos vivos, con un crecimiento logarítmico significativo (p=0,03). Representó 24,9% de todos los recién nacidos a término. La tasa de cesárea se incrementó de 31,2% a 51,1% y su crecimiento fue similar al de los término completo. Se asoció al RNTP con mayor probabilidad de tener bajo peso al nacer (OR:5,33; IC 95%: 4,50-6,30), ser pequeño para la edad gestacional (OR:3,14; IC 95%: 2,69- 3,66), nacer por cesárea (OR: 3,15; IC 95%: 3,01-3,29), tener estancia hospitalaria de 3 días a más (OR: 1,46; IC 95%: 1,39-1,54), morbilidad respiratoria (OR: 1,81; IC 95%: 1,38-2,37) como neumonía (OR:3,02; IC 95%: 1,70-5,38), membrana hialina (OR: 4,17; IC 95%: 1,56-11,33) y taquipnea transitoria (OR: 2,95; IC 95%: 1,79-4,85); y malformaciones congénitas (OR: 1,46; IC 95%: 1,17-1,82), hiperbilirrubinemia (OR: 1,23; IC 95%: 1,02-1,49) y mortalidad neonatal (OR: 2,17; IC 95%: 1,45-3,23). Conclusión: La frecuencia de recién nacidos a término precoz en el hospital Hipólito Unanue de Tacna se incrementó en los últimos 15 años y se asoció a mayor riesgo de problemas respiratorios y mortalidad neonatal

Objective: To determine the frequency, cesarean section rate and morbidity and mortality risks for early term newborns. Material and methods: Non-experimental, cross-sectional study. We included single term live neonates born in Hipolito Unanue Hospital in Tacna from 2000 to 2014 (n= 45332). Early term newborns from 37 to 38 6/7 weeks (n= 11276), were compared with full term newborns from 39 to 41 6/7 weeks (n= 34056). We used frequencies and rates per 100 live births, odds ratios (OR) with 95% confidence intervals (95% CI), logarithmic regression and "t" test for independent samples. The Perinatal Computer System database was used. Results: The frequency of preterm infants was 22.5 per 100 live newborns, with a significant logarithmic growth (p= 0.03). This accounted for 24.9% of all full term newborns. The cesarean section rate increased from 31.2% to 51.1% and its growth was similar to that of full term newborns. It was associated with a higher risk of low birth weight (OR: 5.3; 95% CI:4.5-6.3), small for gestational age babies (OR: 3.14; 95% CI: 2.69-3.66), being born by cesarean section (OR: 3.15; 95% CI: 3.01-3.29), hospital stay of 3 days or more (OR: 1.46; 95% CI: 1.39-1,54), respiratory morbidities (OR: 1.81; 95% CI: 1.38-2.37), such as pneumonia (OR: 3.02; 95% CI: 1.70-5.38), hyaline membrane (OR: 4.17; IC 95% CI: 1.56-11.33), and transient tachypnea (OR: 2.95; 95% CI: 1.79-4.85); and congenital malformations (OR: 1.46; IC 95% CI: 1.17-1.82), hyperbilirubinemia (OR: 1.23; 95% CI: 1.02-1.49), and neonatal mortality (OR: 2.17; 95% CI: 1.45-3.23). Conclusion: The frequency of early term newborns in Hipolito Unanue Hospital in Tacna increased in the last 15 years, and it was associated with an increased risk of respiratory problems and neonatal mortality

Relations between hypertensive disorders in pregnancy and subsequent risk of early-term birth:a birth cohort study / 中华流行病学杂志

Objective To evaluate the relations between hypertensive disorders (HDP) in pregnancy and early-term birth.Methods A total of 3 474 pregnant women were consecutively recruited.Demographic information was collected in early pregnancy.HDP was diagnosed in the first,second and third trimesters,respectively.On the basis of precise evaluation on gestation age,early-term birth was defined as gestational age of 37-38 weeks + 6 days.Logistic regression models were conducted to examine the associations between HDP and early-term birth.Results The current study included 3 260 pregnant women,with the rates of HDP,pregnancy-induced hypertension syndrome and pre-eclampsia as 6.0％ (n=194),4.2％ (n=137) and 1.8％ (n=57),respectively.After controlling for potential confounders,no significant differences between pregnancy-induced hypertension syndrome and early-term birth (OR=1.49,95％C1:0.94-2.36) were found.Pre-eclampsia appeared to have increased the risk of early-term birth (OR=4.46,95％ CI:2.09-9.54).Conclusion Pre-eclampsia could significantly increase the risk of early-term birth.This finding suggested that early detection and intervention programs were helpful in reducing the risk of early-term birth.

Relations between hypertensive disorders in pregnancy and subsequent risk of early-term birth:a birth cohort study / 中华流行病学杂志

Objective To evaluate the relations between hypertensive disorders (HDP) in pregnancy and early-term birth.Methods A total of 3 474 pregnant women were consecutively recruited.Demographic information was collected in early pregnancy.HDP was diagnosed in the first,second and third trimesters,respectively.On the basis of precise evaluation on gestation age,early-term birth was defined as gestational age of 37-38 weeks + 6 days.Logistic regression models were conducted to examine the associations between HDP and early-term birth.Results The current study included 3 260 pregnant women,with the rates of HDP,pregnancy-induced hypertension syndrome and pre-eclampsia as 6.0％ (n=194),4.2％ (n=137) and 1.8％ (n=57),respectively.After controlling for potential confounders,no significant differences between pregnancy-induced hypertension syndrome and early-term birth (OR=1.49,95％C1:0.94-2.36) were found.Pre-eclampsia appeared to have increased the risk of early-term birth (OR=4.46,95％ CI:2.09-9.54).Conclusion Pre-eclampsia could significantly increase the risk of early-term birth.This finding suggested that early detection and intervention programs were helpful in reducing the risk of early-term birth.

Neonatal outcomes in early term neonates versus term neonates in a tertiary care hospital – A cross sectional comparative study.

Background: Preterm birth is one of the chief causes of neonatal mortality and morbidity. The larger studies presented higher rate of adverse outcomes in association to term infants in contrast of neonatal mortality and morbidity. The majority of studies confirmed significantly higher rate of adverse outcomes in preterm in the contrast of neonatal mortality and morbidity. In this contest, we studied Ramprakash MA, Charanraj H, Manikumar S, Srinivasan K, Umadevi L, Giridhar S, Rathinasamy. Neonatal outcomes in early term neonates versus term neonates in a tertiary care hospital - A cross sectional comparative study. IAIM, 2016; 3(4): 21-26. Page 22 the association between different antenatal parameters between early term neonates and full term neonates and to compare neonatal complications. Materials and methods: A total 180 neonates born in the study setting, for a period of 6 months were included and study was conducted in Department of Neonatology and Obstetrics and Gynecology in a tertiary care teaching hospital in south India. A structured and validated case report form was designed for the purpose of data collection. The tool was validated by including the inputs from five experts in the subject area. Descriptive analysis of demographic parameters, antenatal and intra natal parameters were done. Chi square test was used to assess the statistical significance of the association. P value < 0.05 was considered as statistically significant. IBM SPSS version 21 was used for statistical analysis. Results: A total of 180 infants were included in the study, out of which 92 infants (51.1%) were early term and the remaining 88 (48.9%) were full term infants. The odds of early term pregnancy were 2.44 (95 % CI 1.04 to 5.7, p value 0.028) times higher in diabetic mothers, compared to mothers without diabetes. The odds of early term pregnancy was 4.08(95% CI 1.66 to 10.06, p value 0.001) for maternal hypertension and 11.81(95% CI 1.50 to 93.77, p value 0.004) for maternal anemia. The proportion of LSCS was quite high in early term pregnancy, compared to term pregnancy (52.2% Vs 18.2%, p value <0.001). The proportion of small for gestational age (SGA) babies was 29.7% in early term pregnancies (P value 0.011). The odds of hypoglycemia were 3.42 times more in ET pregnancies, compared to full term pregnancies (OR 3.423, 95 % CI 1.37 to 8.52, p value 0.006). Conclusion: The early-term delivery is associated with greater morbidity. There was reasonable relationship was evident involving maternal diabetes mellitus, hypertension, anemia, IUGR and early term pregnancy. The proportion of LSCS was reasonably high in early term pregnancy with slightly higher proportion small for gestational age babies. Neonatal intensive care admissions were found higher in early term than full term pregnancies. Further, there is continual relationship between gestational age and neonatal morbidity from early pregnancy

Recién nacido a término precoz: incidencia y morbilidad perinatal / Early term newborn: incidence and perinatal morbidity

La incidencia global de nacimientos a término antes de las 39 semanas ha aumentado, en parte por el auge de inducciones y cesáreas electivas antes de esta edad gestacional. Los neonatos a término precoces, aquellos nacidos entre 370/7 y 386/7 semanas, pueden tener mayor riesgo de complicaciones que los nacidos a partir de las 39 semanas. Determinar la incidencia denacimientos a término precoces y su asociación con complicaciones posnatales inmediatas. Estudio analítico de cohorte que abarcó una población de 2648 nacimientos; se estimó la incidencia de nacimientos a término precoces y su frecuencia de complicaciones posnatales. De los 2648 niños, 2144 nacieron a término. La incidencia general de nacimiento a término precoz fue 24% (635/2648), mientras que el 29,6% de todos los niños a término fue conformado por recién nacidos menores de 39 semanas (635/2144). El 16,3% (104/635) de éstos presentó alguna complicación aguda. Las causas primarias de admisión fueron las enfermedades respiratorias y la ictericia. En comparación a los nacidos a las 39 semanas, los niños a término precoces tuvieron mayor riesgo de complicaciones agudas (RR 2,1), morbilidad respiratoria (RR 4,1) y admisión a cuidados intensivos (RR 4,7). La incidencia de nacimientos a término antes de las 39 semanas es alta en nuestra poblaciòn. Los neonatos a término precoces representan un tercio de los nacidos a término y conllevan un riesgo aumentado de complicaciones. Se requieren medidas preventivaspara evitar el nacimiento no indicado antes de las 39 semanas

The global incidence of early term births has increased worldwide, primarily because of a continuous increment ininductions and cesarean sections performed before 39 weeks’ gestation. Early term infants, defined as those born between 370/7 and 386/7 weeks, entail a higher risk of morbidity than their full term peers. To know the incidence of early term births and theirassociation with the risk of acute neonatal complications. A cohort observational study of 2648 newborn infants was undertaken. Incidence of early term infants and frequency of admissions for acute complications were measured. 2144 infants of the whole population were full-term infants. Total incidence of early term birth was 24% (635/2648). Early term newborns represented 29.6% of all term infants (635/2144). 104 (16.3%) of all early term infants had to be admitted because of complications. Main causes ofadmission were respiratory distress and jaundice. Early term infants had an increased risk of acute complications (RR 2.1), respiratory morbidity (RR 4.1) and admission to intensive care (RR 4.7). Conclusions: The incidence of early term births in our institution is high. Early term infants have a definite risk of complications. Greater attention needs to be paid to the prevention of non-indicated births before 39 weeks’ gestation