Proper Time of Delivery to Decrease Minor Perinatal Morbiditles / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: Much emphasis has been placed on the morbidity and mortality of infants delivered before 32 weeks of gestation, including intraventricular hemorrhage and respiratory distress. The incidence of these complications and their association with long-term sequelae are well defined. This information is important, especially when decisions regarding delivery have to be made. Although delivery at >32 weeks of gestation may be considered free of serious sequelae of prematurity, morbidities are still associated with delivery between 32 and 36 weeks of gestation. The purpose of this study is to determine the incidence of minor morbidities associated with premature delivery between 32 and 36 weeks of gestation. We tried to find out the proper time to decrease the minor perinatal morbidities and the adverse effect of tocolytic treatment. METHOD: The study population is consisted of infants delivered between 20 and 36 weeks of gestation at Kang Nam St. Mary's hospital from 1995 to 1999. Maternal and neonatal charts were abstracted for maternal past history, pregnancy complications and neonatal demographics comparing complications present at each gestational week. Mann-Whitney test and x2 test were used to assess statistical significance. RESULTS: There was no significant difference of delivery time due to maternal age and parity. There was increased risk of low Apgar score and low birth weight before 34 weeks of gestation. Neonatal death was significantly high before 32 weeks of gestation. Neonatal death, sepsis, intraventricular hemorrhage, respiratory distress, ventilatory equipment use was significantly high before 32-33 weeks of gestation. Hypothermia, feeding difficulty, jaundice, NICU admission was significantly high before 30, 32, 35, 35 weeks of gestation. So it is approved that minor perinatal morbidity was decreased after 34-35 weeks of gestation. CONCLUSION: Major morbidity was significantly high before 32-33 weeks of gestation and Minor morbidity was significantly high before 34 weeks of gestation. Therefore considering of minor and major morbidity, it is reasonable to postpone the preterm delivery until 34 weeks of gestation.