Featured Research

from universities, journals, and other organizations

Babies born at 37 and 38 weeks at higher risk for adverse health outcomes

Date:
October 2, 2013
Source:
University at Buffalo
Summary:
Babies considered "early-term," born at 37 or 38 weeks after a mother's last menstrual period, may look as healthy as full-term babies born at 39-41 weeks, but a study has found that many of them are not.

Although the early-term babies in the study appeared to be mature, providing a false assurance to clinical providers and parents, and they did well on the Apgar scores, they were nevertheless physiologically immature.
Credit: Douglas Levere

Babies considered "early-term," born at 37 or 38 weeks after a mother's last menstrual period, may look as healthy as full-term babies born at 39-41 weeks, but a study published by University at Buffalo physicians in JAMA Pediatrics has found that many of them are not.

The study is considered the first population-based, countywide assessment of neonatal morbidity among early-term infants based on individual medical records in the U.S.

"Our results show the need for an increased awareness among health care providers that even though we consider babies born at 37 or 38 weeks almost term, they are still, to a large extent, physiologically immature," says Shaon Sengupta, MD, corresponding author and formerly a UB medical resident in the Department of Pediatrics and Women and Children's Hospital of Buffalo. She is currently doing a neonatal-perinatal medicine fellowship at Children's Hospital of Philadelphia.

The UB researchers found that these early-term babies were at significantly higher risk for adverse outcomes. They also found that birth by elective cesarean section pushed those risks even higher, from 9.7 percent risk of admission to neonatal intensive care with vaginal deliveries to 19 percent following cesarean section.

The research covered nearly 30,000 live births in Erie County (which includes the city of Buffalo) from Jan. 1, 2006 through Dec. 31, 2008.

In an accompanying editorial, William Oh of Brown University and Tonse N. K. Raju of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, said that the findings "…have important implications for obstetric and neonatal care and research. The findings reinforce the concept that maturation is a continuum and any preset gestational age cannot be assumed to provide a clear separation between immaturity and mature."

The study was precipitated by observations among neonatologists that babies born at 37 or 38 weeks had more adverse health outcomes than those born at 39 to 41 weeks,

according to Satyan Lakshminrusimha, MD, senior author on the study, associate professor of pediatrics in the UB School of Medicine and Biomedical Sciences and chief, division of neonatology at Women and Children's Hospital of Buffalo. He has worked in the hospital's Neonatal Intensive Care Unit (NICU) since 1996.

"We were seeing a significant number of infants born at 37 weeks who looked big and pretty healthy, but who, within a few hours of birth were developing low blood sugar, difficulty in breathing or needed antibiotics, necessitating admission to the neonatal intensive care unit," says Lakshminrusimha.

After evaluating admission patterns among newborn infants between 37 and 41 weeks of gestation at Women and Children's Hospital, Lakshminrusimha, Sengupta and colleagues found that these early-term infants were more likely to suffer some morbidity within a few hours of birth.

To see if these patterns were valid in a wider population, they undertook the larger, county-wide study, conducting an analysis of births at Women and Children's, Millard Fillmore Suburban, Sisters of Charity Hospital and Mercy Hospital, located either in the city of Buffalo or its nearby suburbs.

These data showed similar patterns. Adverse outcomes experienced by the early term babies included hypoglycemia (4.9 percent versus 2.5 percent of full-term babies), admission to the neonatal intensive care unit (8.8 percent versus 5.3 percent, the need for respiratory support (2.0 percent versus 1.1 percent), the need for intravenous fluids (7.5 percent versus 4.4 percent) intravenous antibiotics (2.6 percent versus 1.6 percent) and mechanical ventilation or intubation, which was required in .6 percent of early term babies versus .1 percent in full-term babies.

"Although these early-term babies appeared to be mature, providing a false assurance to clinical providers and parents, and they did well on the Apgar scores, they are nevertheless physiologically immature," notes Lakshminrusimha.

The data revealed, for example, that twice as many of these early term babies needed mechanical ventilation and the need for lung surfactant use was seven times higher than in term babies.

The data also show that early term babies delivered by cesarean section were at a higher risk -- by 12.2 percent -- for admission to the NICU compared with full-term babies and at 7.5 percent higher risk for morbidity compared with term births.

In particular, the study points out that cesarean delivery is a strong predictor of neonatal morbidity at early-term gestation. Lakshminrusimha notes that the need for respiratory support is increased for babies delivered by cesarean section who may retain their fetal lung fluid, since they do not experience the hormonal changes of labor, which clear the fluid from the lungs.


Story Source:

The above story is based on materials provided by University at Buffalo. The original article was written by Ellen Goldbaum. Note: Materials may be edited for content and length.


Journal Reference:

  1. Shaon Sengupta. Adverse Neonatal Outcomes Associated With Early-Term Birth. JAMA Pediatrics, 2013; DOI: 10.1001/jamapediatrics.2013.2581

Cite This Page:

University at Buffalo. "Babies born at 37 and 38 weeks at higher risk for adverse health outcomes." ScienceDaily. ScienceDaily, 2 October 2013. <www.sciencedaily.com/releases/2013/10/131002092633.htm>.
University at Buffalo. (2013, October 2). Babies born at 37 and 38 weeks at higher risk for adverse health outcomes. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2013/10/131002092633.htm
University at Buffalo. "Babies born at 37 and 38 weeks at higher risk for adverse health outcomes." ScienceDaily. www.sciencedaily.com/releases/2013/10/131002092633.htm (accessed October 20, 2014).

Share This



More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Microneedle Patch Promises Painless Pricks

Microneedle Patch Promises Painless Pricks

Reuters - Innovations Video Online (Oct. 18, 2014) Researchers at The National University of Singapore have invented a new microneedle patch that could offer a faster and less painful delivery of drugs such as insulin and painkillers. Video provided by Reuters
Powered by NewsLook.com
Raw: Nurse Nina Pham Arrives in Maryland

Raw: Nurse Nina Pham Arrives in Maryland

AP (Oct. 17, 2014) The first nurse to be diagnosed with Ebola at a Dallas hospital walked down the stairs of an executive jet into an ambulance at an airport in Frederick, Maryland, on Thursday. Pham will be treated at the National Institutes of Health. (Oct. 16) Video provided by AP
Powered by NewsLook.com
Raw: Cruise Ship Returns to US Over Ebola Fears

Raw: Cruise Ship Returns to US Over Ebola Fears

AP (Oct. 17, 2014) A Caribbean cruise ship carrying a Dallas health care worker who is being monitored for signs of the Ebola virus is heading back to Texas, US, after being refused permission to dock in Cozumel, Mexico. (Oct. 17) Video provided by AP
Powered by NewsLook.com
Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

AFP (Oct. 17, 2014) All four suspected Ebola cases admitted to hospitals in Spain on Thursday have tested negative for the deadly virus in a first round of tests, the government said Friday. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins