Maternal risk factors and immediate outcome of late preterms

ABSTRACT

Background: This study was conducted to analyse the immediate outcome of late preterm babies and also to evaluate the various maternal risk factors in these babies so that close monitoring of these babies for the complications is done and immediate problems can be addressed.Methods: Prospective observational study done in level 3 NICU setting for 6 months. All babies born between 34-36/7 weeks are included in the study and they constitute the cases. Term (above 36 weeks 6 days gestation) newborns babies born during the study period are controls. Maternal history is taken in detail. Risk factors during pregnancy including maternal age, gravida, mode of delivery, medical conditions and birth details. Baby details like gestational age, sex, birth weight, and neonatal morbidities are recorded. The babies are either shifted to NICU or to mother's side based depending on the baby's condition. All of them are followed up till discharge.Results: 89 late preterm babies born in the hospital during the study period are included in the study. Out of 89 babies 45are females constituting 50.6% and 44are male babies constituting 49.4%. 20 (22.5%) babies had gestational age between 34-35 weeks.29 babies (32.5 %) had gestational age between 35-36 weeks and 40 babies (45%) are between 36-37 weeks of gestation. 47 babies (52.9%) have birth weight between 1.5-2.49 kg.42 babies (47.1%) have birth weight between 2.5-3.5 kg. The number of babies born by LSCS were 48 (54%) and 41 babies 46% are born through vaginal route.42 babies constituting 48.3% are appropriate for gestational age and 43 babies (49.4%) are small for gestationalage.34 (39.1%) babies required NICU admission and 55 (60.9%) babies did not require NICU admission. Among the maternal risk factors PIH was the commonest risk factor in 22babies (24.7 %), followed by PROM13 (14.6 %), oligohydramnios 6 (6.7 %) ,twin gestation 6 (6.7 %), MSAF 3 (3.4%), IDM 3 (3.4%), Antepartum hemorrhage 3 (3.4%), eclampsia 1 (1.1%) and maternal cardiac disease 1.1%. Neonatal morbidities are 25 late preterm babies had jaundice (28.7%) followed by RDS in 15 (17.2%), sepsis in 9 (10.3%), NEC 2 (2.3%), Hypoglycemia 5 (5.6%) late preterm babies required ventilation/ CPAP constituting 5.7%. Surfactant was used in 2 late preterm babies 2.3%. 87 babies (97.8%) got discharged and mortality is 2.2%.Conclusions: Late prematurity is associated with significant neonatal morbidity.