RT Journal Article
SR Electronic
T1 PC.11 Neonatal outcomes of late and moderately preterm infants following spontaneous and no-spontaneous onset of labour
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP A39
OP A40
DO 10.1136/archdischild-2014-306576.114
VO 99
IS Suppl 1
A1 EM Boyle
A1 S Johnson
A1 ES Draper
A1 B Manktelow
A1 S Seaton
A1 TA Evans
A1 LK Smith
A1 N Marlow
A1 DJ Field
YR 2014
UL http://fn.bmj.com/content/99/Suppl_1/A39.3.abstract
AB Background Infants born late/moderately preterm (LMPT; 32–36 weeks’ gestation) have increased risk of adverse outcomes compared with term-born infants. It is unclear whether differences relate to prematurity per se, or to problems occurring during pregnancy leading to medically indicated delivery. Aim To explore outcomes in LMPT and term infants born following spontaneous onset of labour (SOL) and non-spontaneous onset of labour (NSOL). Methods In a prospective, population-based study, we compared neonatal outcomes of LMPT normally formed singleton infants according to whether birth followed SOL or NSOL. Outcomes included resuscitation at delivery, respiratory support, fluid and nutritional support. Results 907 LMPT and 972 term-born infants were studied. NSOL occurred in 42.1% of LMPT and 34.2% of term births. Of these, 50.5% of LMPT and 31.9% of term infants were delivered by caesarean section not preceded by labour. The median (range) gestation was 35+6 (32+0, 36+5) weeks for both preterm groups and for term babies was 40+1 (37+0, 43+4) and 39+5 (37+0, 42+6) for SOL and NSOL respectively. LMPT infants whose mothers had NSOL were more likely to receive resuscitation (21.7% v 14.5%; P = 0.005), respiratory support (16.2% v 8.6%; P = 0.001), intravenous fluids (34% v 21.5%; P = 0.005) and parenteral nutrition (6.0% v 1.7%; P = 0.001). In term-born infants, there were no differences in these outcomes between NSOL and SOL groups. Conclusion Delivery following obstetric intervention is commoner at LMPT than term gestation. Effects associated with medically indicated LMPT delivery compound effects caused by prematurity. Further exploration of delivery indications may identify particularly high-risk groups.