Title: Short Term Neonatal Morbidities of Post-Term Births: A Prospective Cohort Study
Authors: Dr Sujit Nath Choudhury, Dr Pranav N Saji
DOI: https://dx.doi.org/10.18535/jmscr/v8i6.82
Abstract
Introduction: Post-term pregnancy is defined as pregnancy reaching to or extending beyond 42 weeks of gestation from the last menstrual period. The introduction of routine ultrasound for gestational age dating has significantly reduced the incidence of post-term pregnancy. An increased risk of perinatal mortality and morbidity also found in the post-term babies. Maternal factors also plays a major role in delivery for ≥42 completed gestational weeks.
Materials and Methods: This study is a prospective cohort study conducted on 110 live births born between April 2019 and March 2020 in a tertiary care hospital. Data were collected using a structured questionnaire and twice daily examination of the baby. The complication developed is recorded and detailed maternal history also taken.
Results: The prevalence of post-term births to be 3.9%. Advanced maternal age, oligohydramnios and previous history of post term delivery were found to be the major factor responsible for the post-term delivery. Meconium staining of amniotic fluid, Meconium aspiration syndrome, birth asphyxia, polycythemia, hypocalcemia and hypoglycemia are found to have higher incidence in post-term babies. Neonatal mortality in post-term neonates in our study was 10.1%.
Conclusion: Primiparity, advanced maternal age and previous post-term delivery were found to be the strongest risk factors for post-term pregnancy. Study also demonstrated an association between post-term pregnancy and an increased risk of adverse neonatal outcome for post-term babies. This should be kept in mind by obstetricians when considering the management of post-term pregnancy as well as by paediatricians who need to be aware of the higher rate of complications in post-term neonates.
References
- World Health Organization. Recommended definitions, terminology and format for statistical tables related to the perinatal period and use of a new certificate for cause of perinatal deaths. Modifications recommended by FIGO as amended October 14, 1976. Acta Obstet Gynecol Scand 1977;56:247-53.
- Martin Ja, Hamilton be, Sutton Pd et al. births: final data for 2005. natl Vital Stat Rep. 2007; 56:1-103.
- Kistka ZA, Palomar L, Boslaugh SE, De Baun MR, DeFranco EA, Muglia LJ. Risk for postterm delivery after previous postterm delivery. Am J Obstet Gynecol. 2007; 196: 241e1–6.
- Collins JW, Schulte nF, George l et al. Postterm delivery among African americans, Mexican americans and Whites in Chicago. ethn dis. 2001;11:181-7.
- Clausson B, Cnattingius S, Axelsson O. Outcomes of post-term births: the role of fetal growth restriction and malformations. Obstet Gynecol 1999;94:758–62
- Clausson B, Cnattingius S, Axelsson O. Outcomes of post-term births: the role of fetal growth restriction and malformations. Obstet Gynecol. 1999; 94(5):758–62.
- American College of Obstetricians and Gynecologists. Practice bulletin no. 146: management of late-term and postterm pregnancies. Obstet Gynecol 2014;124(2 Pt 1):390–6.
- Linder N, Hiersch L, Fridman E, Klinger G, Lubin D, Kouadio F, Melamed N. Post-term pregnancy is an independent risk factor for neonatal morbidity even in low-risk singleton pregnancies. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2017 Jul 1;102(4):F286-90.
- Roos N, Sahlin L, Ekman-Ordeberg G, et al; Maternal risk factors for postterm pregnancy and cesarean delivery following labor induction. Acta Obstet Gynecol Scand. 2010 Aug89(8):1003-10.
- Roos N, Sahlin L, Ekman-Ordeberg G, Kieler H. Maternal risk factors forpost-term pregnancy and caesarean delivery following labor induction. Acta Obstetriciaet Gynecologica. 2010;89: 1003–10. doi:10.3109/00016349.2010.50009.
- Ahanya SN, Lakshmanan J, Morgan BL, et al. Meconium passage in utero: mechanisms, consequences, and management. Obstet Gynecol Surv 2005;60: 45–56.
- David AN, Njokanma OF, Iroha E. Incidence of and factors associated with meconium staining of the amniotic fluid in a Nigerian University Teaching Hospital. J Obstet Gynaecol 2006;26:518–20.
- Razzaq A, Quddusi AI, Nizami N. Risk factors and mortality among newborns with persistent pulmonary hypertension. Pakistan journal of medical sciences. 2013 Sep;29 (5):1099.
- Dias E, Gada S. Glucose levels in newborns with special reference to hypoglycemia: a study from rural India. Journal of clinical neonatology. 2014 Jan;3(1):35.
- Clausson B, Cnattingius S, Axelsson O. Outcomes of post-term births: the role of fetal growth restriction and malformations. Obstetrics & Gynecology. 1999 Nov 1;94(5):758-62.