TY - JOUR T1 - Post-term pregnancy is an independent risk factor for neonatal morbidity even in low-risk singleton pregnancies JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - F286 LP - F290 DO - 10.1136/archdischild-2015-308553 VL - 102 IS - 4 AU - Nehama Linder AU - Liran Hiersch AU - Elana Fridman AU - Gil Klinger AU - Daniel Lubin AU - Franck Kouadio AU - Nir Melamed Y1 - 2017/07/01 UR - http://fn.bmj.com/content/102/4/F286.abstract N2 - Objective To determine the independent association of post-term pregnancy with neonatal outcome in low-risk newborns.Design Retrospective cohort.Setting Tertiary university-affiliated medical centre.Patients All newborns of low-risk singleton pregnancies born at 39+0 to 44+0 weeks’ gestation over a 5-year period. Exclusion criteria: multiple gestation, maternal hypertensive disorder, diabetes or cholestasis, placental abruption or intrapartum fever (>38°C), small for gestational age (<10th centile) and major congenital or chromosomal anomalies.Interventions None.Outcome measures Admission to the neonatal intensive care unit (NICU), hospital length of stay, 5-min Apgar score, birth trauma, respiratory, neurological, metabolic and infectious morbidities and neonatal mortality. The adverse outcome rate was compared among three groups based on gestational age at birth: post-term (≥42+0 weeks), late term (41+0 to 41+6 weeks) and full term (39+0 to 40+6 weeks).Results Of the 23 524 eligible neonates, 747 (3.2%) were born post-term, 4632 (19.7%) late term and 18 145 (77.1%) full term. Women in the post-term group versus the late-term group had a significantly higher rate of caesarean section (8.9% vs 5.6%, p<0.001) and operative vaginal delivery (9.6% vs 7.4%, p=0.024). Post-term pregnancy versus full-term pregnancy was associated with an increased risk of NICU admission (OR 2.0, 95% CI 1.4 to 2.8), respiratory morbidity (OR 2.2, 95% CI 1.3 to 3.8) and infectious morbidity (OR 1.88, 95% CI 1.32 to 2.69). Post-term pregnancy versus late-term pregnancy was similarly associated with an increased risk of NICU admission (OR 2.0, 95% CI 1.4 to 2.9), respiratory morbidity (OR 2.7, 95% CI 1.5 to 5.0) and infectious morbidity (OR 1.8, 95% CI 1.2 to 2.7) and with hypoglycaemia (OR 2.6, 95% CI 1.2 to 5.4). Post-term delivery was not associated with neonatal mortality.Conclusions Post-term pregnancy is an independent risk factor for neonatal morbidity even in low-risk singleton pregnancies. ER -