Document Detail


Preterm delivery for maternal or fetal indications: maternal morbidity, neonatal outcome and late sequelae in infants.
MedLine Citation:
PMID:  10826581     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess maternal morbidity, and neonatal outcome and especially long term sequelae in infants born preterm due to maternal or fetal indications. DESIGN: Analysis of retrospective cohort. SETTING: Oulu University Central Hospital, Finland. POPULATION: One hundred and three women, who were between the 24th and the 33rd week of pregnancy, delivered by caesarean delivery because of maternal or fetal indications. They were matched with 103 women who had spontaneous preterm delivery at corresponding gestational weeks between 1990-1997. MAIN OUTCOME MEASURES: Maternal morbidity, reasons for caesarean delivery, neonatal mortality and morbidity rates, and later development of the infants. RESULTS: Pre-eclampsia was diagnosed in 57% of the women in the indicated group and only in one woman in the control group. All infants in the indicated group and almost a third in the control group were born by caesarean birth; the main indication was threatening fetal asphyxia. There was a significant difference in neonatal mortality rates between the groups (175 vs 78 per thousand live births in the indicated vs control infants; RR 2.3, 95% CI 1.02, 4.9) and the main cause of death was respiratory insufficiency: 64% in the indicated group and 22% in the controls; RR 2.9, 95% CI 0.8, 10. Respiratory distress syndrome occurred more often (73% vs 53%, RR 1.4, 95% CI 1.1, 1.7) and it was more severe and more complicated in infants in the indicated group, compared with those in the control group. Symptomatic chronic lung disease at one year of age was more common in infants in the indicated group than in the control group (15% vs 3%; RR 4.6, 95% CI 1.4, 15.9). CONCLUSIONS: Not only the risks of neonatal mortality and morbidity but also long term pulmonary consequences, appear to be greater in infants born preterm by indicated delivery than in preterm infants born spontaneously at corresponding weeks.
Authors:
M Kurkinen-Räty; M Koivisto; P Jouppila
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  107     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-06-05     Completed Date:  2000-06-05     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  648-55     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynaecology, University of Oulu, Finland.
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MeSH Terms
Descriptor/Qualifier:
Asphyxia Neonatorum / complications*
Cesarean Section*
Female
Humans
Infant
Infant Mortality*
Infant, Newborn
Infant, Premature
Lung Diseases / epidemiology*
Morbidity
Obstetric Labor, Premature / complications*
Pre-Eclampsia / complications*
Pregnancy
Regression Analysis
Respiratory Distress Syndrome, Newborn / epidemiology
Respiratory Insufficiency / complications
Retrospective Studies

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


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