Retrospective Evaluation of Neonatal Morbidites of Term and Early Term Newborns: A Single Tertiary Nicu Center Results

Aim: Full-term neonates born between 37 and 41 weeks’ gestational age have been considered a homogeneous, low-risk group. In this study we aimed to compare the short-term morbidity of early-term vs term neonates in a county-based birth cohort using the primary objective of admission to a neonatal intensive care unit (NICU) or neonatology service.

Materials and Methods: Retrospective population-based 2-year birth cohort study(January 1, 2013–December 31, 2014) at arasında Zekai Tahir Burak Women’s Health Training and Research Hospital Newborn Intensive Care Unit (NICU). Gestational age of early term (370/7-386/7 weeks) vs term (390/7-410/7 weeks). The main outcome measure of the study was admission to the NICU or neonatology service. Second outcome measures were respiratory problems, respiratory support requirement, duration of hospital stay, metabolic disturbances, intravenous fluid requirement, need for antibiotic treament, and indirect hyperbilirubinemia needing phototherapy.

Results: There were 37087 live births, of which 30137 had a gestational age between 37 and 41 weeks. Of all live births, 11446 (30.8%) were early term. Compared with term infants, early-term neonates had significantly higher risks for the following: hypoglycemia, NICU or neonatology service admission, need for respiratory support, requirement for intravenous fluids, treatment with intravenous antibiotics, and mechanical ventilation or intubation. However, after adjusting for sex, birth weight, gestational age and maternal age in a multivariate logistic regression model, only higher risk for respiratory morbidity persisted (OR:1.28 [1.02-1.59]; p=0.02). In contrast to that, full-term infants was found to be at higher risk for hypernatremia compared to early-term infants.

Conclusion: Early term birth is associated with a higher neonatal morbidity and NICU admissions, and gestational age is known to be the most important determinant of this condition. Therefore, with advanced maternal care and better understanding of the factors causing early term birth will lead to prevention and successfull management of this risk group.