American journal of obstetrics and gynecology · 2011
Nonspontaneous late preterm birth: etiology and outcomes.
СтатьяНазвание и аннотация: Перевод в очереди
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Gyamfi-Bannerman Cynthia, Fuchs Karin M, Young Omar M, Hoffman Matthew K
Аннотация
OBJECTIVE: We sought to determine the proportion of evidence-based (EB), vs non-EB (NEB) iatrogenic late preterm birth, and to compare corresponding rates of neonatal intensive care unit (NICU) admission.
STUDY DESIGN: We performed a retrospective cohort study. Cases were categorized as EB or NEB. NICU admission was compared between groups in both univariate and multivariate analysis.
RESULTS: Of 2693 late preterm deliveries, 32.3% (872/2693) were iatrogenic; 56.7% were delivered for NEB indications. Women with NEB deliveries were older (30.0 vs 28.6 years, P = .001), and more likely to be pregnant with twins (18.8% vs 7.9%, P < .001), have private insurance (80.3% vs 59.0%, P < .001), or have a second complicating factor (27.5% vs 10.1%, P < .001). A total of 56% of EB deliveries resulted in NICU admissions. After controlling for confounders, early gestational age (34 vs 36 weeks: odds ratio, 19.34; 95% confidence interval, 4.28-87.5) and mode of delivery (cesarean: odds ratio, 1.88; 95% confidence interval, 1.15-3.05) were most strongly associated with NICU admission.
CONCLUSION: Over half of nonspontaneous late preterm births were NEB. EB guidelines are needed.
STUDY DESIGN: We performed a retrospective cohort study. Cases were categorized as EB or NEB. NICU admission was compared between groups in both univariate and multivariate analysis.
RESULTS: Of 2693 late preterm deliveries, 32.3% (872/2693) were iatrogenic; 56.7% were delivered for NEB indications. Women with NEB deliveries were older (30.0 vs 28.6 years, P = .001), and more likely to be pregnant with twins (18.8% vs 7.9%, P < .001), have private insurance (80.3% vs 59.0%, P < .001), or have a second complicating factor (27.5% vs 10.1%, P < .001). A total of 56% of EB deliveries resulted in NICU admissions. After controlling for confounders, early gestational age (34 vs 36 weeks: odds ratio, 19.34; 95% confidence interval, 4.28-87.5) and mode of delivery (cesarean: odds ratio, 1.88; 95% confidence interval, 1.15-3.05) were most strongly associated with NICU admission.
CONCLUSION: Over half of nonspontaneous late preterm births were NEB. EB guidelines are needed.