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Neonatal outcomes in spontaneous versus obstetrically indicated late preterm births in a nova scotia population.
J Obstet Gynaecol Can. 2012 Dec; 34(12):1158-1166.JO

Abstract

OBJECTIVE

To examine the indications for late preterm delivery in Nova Scotia and to compare the short-term outcomes by type of labour (spontaneous, induced, none).

METHODS

We conducted a population-based retrospective cohort study of late preterm births (34+0 to 36+6 weeks' gestation) between 1988 and 2009 using the Nova Scotia Atlee Perinatal Database. The association between labour type and neonatal outcomes was examined with logistic regression to estimate odds ratios with 95% confidence intervals.

RESULTS

Of the 10 315 late preterm births, 6228 followed spontaneous labour, 2338 followed induction of labour, and 1689 followed Caesarean section with no labour. Babies born following induction were at higher risk of developing hyperbilirubinemia (OR 1.14; 95% CI 1.03 to 1.27) and needing total parenteral nutrition (OR 1.52; 95% CI 1.15 to 1.99) than those born spontaneously. Those born without labour were at higher risk of needing resuscitation (OR 2.43; 95% CI 1.84 to 3.21) and total parenteral nutrition (OR 2.54; 95% CI 1.93 to 3.33) and developing transient tachypnea of the newborn (OR 1.43; 95% CI 1.10 to 1.85), hypoglycemia (OR 1.97; 95% CI 1.63 to 2.39), respiratory distress syndrome (OR 2.33; 95% CI 1.89 to 2.88), necrotizing enterocolitis (OR 3.20; 95% CI 1.07 to 9.53), and apneic spells (OR 1.29; 95% CI 1.05 to 1.59). When adjusted for maternal and fetal factors, odd ratios were only slightly attenuated.

CONCLUSION

Among late preterm babies, those born by Caesarean section without labour are at increased risk of many adverse outcomes, while those born following induction of labour are at increased risk of few of the outcomes studied. Maternal and fetal factors other than those for which adjustment was made may contribute to the differences in outcome by labour type.

Authors+Show Affiliations

Division of Neonatal-Perinatal Medicine, Department of Paediatrics, Dalhousie University, Halifax, NS.Perinatal Epidemiology Research Group, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, NS.Perinatal Epidemiology Research Group, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, NS.Division of Neonatal-Perinatal Medicine, Department of Paediatrics, Dalhousie University, Halifax, NS.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23231798

Citation

Feldman, Kayla, et al. "Neonatal Outcomes in Spontaneous Versus Obstetrically Indicated Late Preterm Births in a Nova Scotia Population." Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstetrique Et Gynecologie Du Canada : JOGC, vol. 34, no. 12, 2012, pp. 1158-1166.
Feldman K, Woolcott C, O'Connell C, et al. Neonatal outcomes in spontaneous versus obstetrically indicated late preterm births in a nova scotia population. J Obstet Gynaecol Can. 2012;34(12):1158-1166.
Feldman, K., Woolcott, C., O'Connell, C., & Jangaard, K. (2012). Neonatal outcomes in spontaneous versus obstetrically indicated late preterm births in a nova scotia population. Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstetrique Et Gynecologie Du Canada : JOGC, 34(12), 1158-1166. https://doi.org/10.1016/S1701-2163(16)35463-9
Feldman K, et al. Neonatal Outcomes in Spontaneous Versus Obstetrically Indicated Late Preterm Births in a Nova Scotia Population. J Obstet Gynaecol Can. 2012;34(12):1158-1166. PubMed PMID: 23231798.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neonatal outcomes in spontaneous versus obstetrically indicated late preterm births in a nova scotia population. AU - Feldman,Kayla, AU - Woolcott,Christy, AU - O'Connell,Colleen, AU - Jangaard,Krista, PY - 2012/12/13/entrez PY - 2012/12/13/pubmed PY - 2014/9/23/medline SP - 1158 EP - 1166 JF - Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC JO - J Obstet Gynaecol Can VL - 34 IS - 12 N2 - OBJECTIVE: To examine the indications for late preterm delivery in Nova Scotia and to compare the short-term outcomes by type of labour (spontaneous, induced, none). METHODS: We conducted a population-based retrospective cohort study of late preterm births (34+0 to 36+6 weeks' gestation) between 1988 and 2009 using the Nova Scotia Atlee Perinatal Database. The association between labour type and neonatal outcomes was examined with logistic regression to estimate odds ratios with 95% confidence intervals. RESULTS: Of the 10 315 late preterm births, 6228 followed spontaneous labour, 2338 followed induction of labour, and 1689 followed Caesarean section with no labour. Babies born following induction were at higher risk of developing hyperbilirubinemia (OR 1.14; 95% CI 1.03 to 1.27) and needing total parenteral nutrition (OR 1.52; 95% CI 1.15 to 1.99) than those born spontaneously. Those born without labour were at higher risk of needing resuscitation (OR 2.43; 95% CI 1.84 to 3.21) and total parenteral nutrition (OR 2.54; 95% CI 1.93 to 3.33) and developing transient tachypnea of the newborn (OR 1.43; 95% CI 1.10 to 1.85), hypoglycemia (OR 1.97; 95% CI 1.63 to 2.39), respiratory distress syndrome (OR 2.33; 95% CI 1.89 to 2.88), necrotizing enterocolitis (OR 3.20; 95% CI 1.07 to 9.53), and apneic spells (OR 1.29; 95% CI 1.05 to 1.59). When adjusted for maternal and fetal factors, odd ratios were only slightly attenuated. CONCLUSION: Among late preterm babies, those born by Caesarean section without labour are at increased risk of many adverse outcomes, while those born following induction of labour are at increased risk of few of the outcomes studied. Maternal and fetal factors other than those for which adjustment was made may contribute to the differences in outcome by labour type. SN - 1701-2163 UR - https://www.unboundmedicine.com/medline/citation/23231798/Neonatal_outcomes_in_spontaneous_versus_obstetrically_indicated_late_preterm_births_in_a_nova_scotia_population_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1701-2163(16)35463-9 DB - PRIME DP - Unbound Medicine ER -