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Delivery between 34 and 38 weeks: what is the burden on maternity and neonatal services?
  1. B Carpenter1,
  2. S Hillman2,
  3. M Sellwood2,
  4. S M Whitten2
  1. 1University College London, London, UK
  2. 2Institute for Women's Health, London, UK

Abstract

Introduction Delivery between 34–38 weeks confers a need for neonatal or transitional care (TC) for some newborns. We aimed to examine incidence of neonatal or TC admission within our service to inform parental counselling and obstetric decision-making in the case of iatrogenic delivery.

Methods All singleton liveborn deliveries between 34 to 37+6 weeks gestation between July and November 2009 within our tertiary unit (5200 deliveries/year) were retrospectively identified and details confirmed from birth registers, neonatal unit (NNU) and TC registers and the Eclipse Maternity information system. Data was analysed using Excel.

Results 438 babies were identified. 73% of babies born between 34 and 34+6 weeks required NNU admission, halving to 36.2% at 35 to 35+6, then 25% and 11.6% at 36 to 36+6 and 37 to 37+6 weeks respectively. Average length of stay in NNU was 8.2 days at 34 to 34+6 weeks, reducing to 5.0, 5.6 and 3.2 days for later gestations. TC admission was 43.2%, 53.2%, 29.5% and 14% for each respective gestation period from 34 to 37+6. Babies admitted to NNU and/or TC had lower birth weights overall compared to those not admitted at equivalent gestations. Indications for admission were predominantly for feeding problems, sepsis, hypo/hyperglycaemia and jaundice.

Conclusions Delivery between 34 and 34+6 weeks, and lower birth weights at all gestations, are more likely to require admission to NNU or TC, with short-term morbidity existing through to 37+6 weeks. Where iatrogenic early delivery is being considered, these figures may help guide clinicians and parents as to the implications of early delivery, and may help maternity units when considering load upon the service.

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