American journal of obstetrics and gynecology · 2011
Elective delivery at 34⁰(/)⁷ to 36⁶(/)⁷ weeks' gestation and its impact on neonatal outcomes in women with stable mild gestational hypertension.
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Barton John R, Barton Lucy A, Istwan Niki B, Desch Cheryl N, Rhea Debbie J, Stanziano Gary J, Sibai Baha M
Аннотация
OBJECTIVE: To examine the frequency of elective delivery and neonatal outcomes in women with stable mild gestational hypertension delivering late preterm.
STUDY DESIGN: The frequency of elective delivery between 1995 and 2007 at gestational age of 34⁰(/)⁷-36⁶(/)⁷ weeks (late preterm), 37⁰(/)⁷-37⁶(/)⁷ weeks, and ≥38⁰(/)⁷ weeks, as well as neonatal outcomes, were studied in singleton gestation with mild gestational hypertension without proteinuria from a large national database.
RESULTS: One thousand eight hundred fifty-eight patients were studied: 607 (33%) were delivered for maternal/fetal reasons and 1251 (67%) were electively delivered. Among the 1251 women delivered electively, 25.5% were late preterm, 24.4% at 37⁰(/)⁷-37⁶(/)⁷ weeks and 50.1% at ≥38⁰(/)⁷ weeks' gestation. Neonatal intensive care unit admission, ventilatory assistance, and respiratory distress syndrome were more common in late-preterm infants. There was no maternal/perinatal mortality.
CONCLUSION: We found that 25.5% of patients with stable mild gestational hypertension, without any maternal or fetal complication, had iatrogenic elective late-preterm delivery. This practice also was associated with increased rates of neonatal complications and neonatal length of stay.
STUDY DESIGN: The frequency of elective delivery between 1995 and 2007 at gestational age of 34⁰(/)⁷-36⁶(/)⁷ weeks (late preterm), 37⁰(/)⁷-37⁶(/)⁷ weeks, and ≥38⁰(/)⁷ weeks, as well as neonatal outcomes, were studied in singleton gestation with mild gestational hypertension without proteinuria from a large national database.
RESULTS: One thousand eight hundred fifty-eight patients were studied: 607 (33%) were delivered for maternal/fetal reasons and 1251 (67%) were electively delivered. Among the 1251 women delivered electively, 25.5% were late preterm, 24.4% at 37⁰(/)⁷-37⁶(/)⁷ weeks and 50.1% at ≥38⁰(/)⁷ weeks' gestation. Neonatal intensive care unit admission, ventilatory assistance, and respiratory distress syndrome were more common in late-preterm infants. There was no maternal/perinatal mortality.
CONCLUSION: We found that 25.5% of patients with stable mild gestational hypertension, without any maternal or fetal complication, had iatrogenic elective late-preterm delivery. This practice also was associated with increased rates of neonatal complications and neonatal length of stay.