Document Detail


Neonatal and 5-year outcomes after birth at 30-34 weeks of gestation.
MedLine Citation:
PMID:  17601899     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the rates of in-hospital death, neonatal complications, and 5-year outcomes of infants born at 30-34 weeks of gestation. METHODS: In nine regions of France, all 2,020 stillbirths and live births at 30, 31, and 32 weeks in 1997 and all 457 births at 33 and 34 weeks in April and October 1997 were recorded. Survivors were evaluated at 5 years of age. RESULTS: Increasing gestational age from 30 to 34 weeks was associated with progressive decreases in in-hospital mortality (from 8.1% to 0.4%) and neonatal complications (respiratory distress syndrome, 43.8% to 2.6%; maternofetal infections, 7.2% to 2.6%; and severe white matter injury, 5.5% to 1.3%). Although infants at 33 and 34 weeks of gestation rarely experienced necrotizing enterocolitis, bronchopulmonary dysplasia, or nosocomial infections, they still required endotracheal ventilation, antibiotics, or parenteral nutrition. At 5 years of age, older gestational age was associated with significant decreases in rates of cerebral palsy (6.3% at 30 weeks and 0.7% at 34 weeks) and mild to severe cognitive impairments (35.3% at 30 weeks and 23.9% at 34 weeks). In singletons, preterm rupture of membranes or preterm labor carried an increased risk of cerebral palsy but not of cognitive impairment. CONCLUSION: Neonates born at 30-34 weeks experienced substantial morbidity and often required admission to neonatal intensive care units. These outcomes suggest that prolonging pregnancies beyond 34 weeks may be desirable whenever possible. Infants born at 30-34 weeks should be carefully monitored to ensure prompt detection and management of neurodevelopmental impairment.
Authors:
Stéphane Marret; Pierre-Yves Ancel; Loïc Marpeau; Laetitia Marchand; Véronique Pierrat; Béatrice Larroque; Laurence Foix-L'Hélias; Gérard Thiriez; Jeanne Fresson; Corinne Alberge; Jean-Christophe Rozé; Jacqueline Matis; Gérard Bréart; Monique Kaminski;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  110     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-02     Completed Date:  2007-07-31     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  72-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Neonatal Medicine, Rouen University Hospital and Inserm Avenir Research Group, Institute for Biomedical Research, University of Rouen, Rouen, France. stephane.marret@chu-rouen.fr
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MeSH Terms
Descriptor/Qualifier:
Cerebral Palsy / epidemiology*
Child, Preschool
Cognition Disorders / epidemiology*
Cohort Studies
Female
Follow-Up Studies
France / epidemiology
Gestational Age*
Humans
Incidence
Infant Mortality
Infant, Newborn
Intensive Care, Neonatal / utilization
Male
Patient Admission / statistics & numerical data
Pregnancy
Pregnancy Trimester, Third
Premature Birth*
Retrospective Studies
Stillbirth / epidemiology
Comments/Corrections
Comment In:
Obstet Gynecol. 2007 Nov;110(5):1171-2; author reply 1172   [PMID:  17978138 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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