Nonspontaneous late preterm birth: etiology and outcomes.

Abstract:

OBJECTIVE:We sought to determine the proportion of evidence-based (EB), vs non-EB (NEB) iatrogenic late preterm birth, and to compare corresponding rates of neonatal intensive care unit (NICU) admission. STUDY DESIGN:We performed a retrospective cohort study. Cases were categorized as EB or NEB. NICU admission was compared between groups in both univariate and multivariate analysis. RESULTS:Of 2693 late preterm deliveries, 32.3% (872/2693) were iatrogenic; 56.7% were delivered for NEB indications. Women with NEB deliveries were older (30.0 vs 28.6 years, P = .001), and more likely to be pregnant with twins (18.8% vs 7.9%, P < .001), have private insurance (80.3% vs 59.0%, P < .001), or have a second complicating factor (27.5% vs 10.1%, P < .001). A total of 56% of EB deliveries resulted in NICU admissions. After controlling for confounders, early gestational age (34 vs 36 weeks: odds ratio, 19.34; 95% confidence interval, 4.28-87.5) and mode of delivery (cesarean: odds ratio, 1.88; 95% confidence interval, 1.15-3.05) were most strongly associated with NICU admission. CONCLUSION:Over half of nonspontaneous late preterm births were NEB. EB guidelines are needed.

journal_name

Am J Obstet Gynecol

authors

Gyamfi-Bannerman C,Fuchs KM,Young OM,Hoffman MK

doi

10.1016/j.ajog.2011.08.007

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

456.e1-6

issue

5

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(11)01040-4

journal_volume

205

pub_type

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