June 16, 2008 Many parents become anxious toward the end of a pregnancy, when women are sleepless, fatigued and finding it difficult to perform their daily activities. Technology during the past 10 years has made labor induction easier and more successful, and now, more than ever before, deliveries are planned during the last few weeks of pregnancies.
But studies are showing that a delivery even two weeks early can be associated with newborn complications, according to Dr. Celeste Durnwald, a maternal-fetal medicine specialist at The Ohio State University Medical Center.
“There is still ongoing development and maturation of the fetus, even in those last few weeks,” notes Durnwald. The consequences of being born early include problems such as jaundice, poor feeding, inability to sit in a car seat without breathing difficulties and, rarely, premature lungs.
These situations are usually not life threatening, but can lead to increased hospital stays, admission to the neonatal intensive care unit, and days of anxiety for the new parents.
The American College of Obstetricians and Gynecologists states that a full term pregnancy is one that has completed 39 weeks. Because of the many recent medical advances, patients and physicians are choosing to push the date of a delivery earlier than ever before, even to 36 weeks gestation, a full month ahead of the mother’s due date. Nationwide, the number of deliveries in this gestational age range increased dramatically in the past decade.
In 1996, 6.9 percent of all births occurred between the 34th and 36th weeks of gestation. In 2005, reports showed 8.1 percent of all births occurring between the 34th and 36th weeks.
Some of these early births are scheduled for good reason, in response to health concerns for baby or mother. “Certainly, a medical problem with the mother’s health, or suspected fetal jeopardy can sometimes necessitate a delivery earlier than otherwise anticipated. Maternal hypertension and poor fetal growth are common reasons. The rate of infant deaths and stillbirths is going down, while the rate of ‘late preterm births’ or ‘near-term births’ is going up,” Durnwald says.
Now, obstetricians are working to slow down the rate of “late preterm births” or “near-term births”; to figure out what the current criteria for preterm births are; and to make sure those criteria are met.
“Healthcare providers and parents must weigh the risks and benefits of the ‘late preterm births,’ realizing there are potential complications for a newborn,” notes Durnwald.
“Even though those last few weeks can seem like months to the patient, I try to emphasize the importance of delivering at a gestational age when the baby gets to go home with the mother and does well in the nursery,” says Durnwald.
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