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Pediatric Cardiovascular Morbidity of the Early Term Newborn
Gil Gutvirtz1, Tamar Wainstock2, Eyal Sheiner1
1Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Insights
Early term delivery, between 37 and 38 weeks gestation, is linked to increased cardiovascular problems in children. This finding highlights potential long-term health risks associated with non-full term births.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Cardiology
- Public Health
Background:
- Gestational age at delivery is a critical factor influencing neonatal and long-term health outcomes.
- Previous research has explored various risks associated with preterm birth, but the specific long-term cardiovascular implications of early term delivery require further investigation.
Purpose of the Study:
- To investigate the association between early term delivery (370/7-386/7 weeks of gestation) and the incidence of long-term pediatric cardiovascular morbidity.
- To compare cardiovascular-related hospitalizations in offspring born at early term versus full term, late term, and post term.
Main Methods:
- A population-based cohort analysis of 223,242 singleton deliveries between 1991 and 2014 at a tertiary medical center.
- Categorization of deliveries into early term, full term, late term, and post term based on gestational age.
- Evaluation of hospitalizations for cardiovascular morbidity up to age 18, employing Kaplan-Meier curves and a multivariable Weibull model to assess risk and control for confounders.
Main Results:
- A significant association was found between early term delivery and increased cardiovascular morbidity hospitalizations in offspring (0.7% vs. 0.6%, 0.6%, 0.5%; P=.01).
- Kaplan-Meier analysis revealed a significantly higher cumulative incidence of cardiovascular-related hospitalizations in the early term group (log-rank P < .001).
- Multivariable analysis identified early term delivery as an independent risk factor for cardiovascular-related hospitalization compared to full term delivery (adjusted HR, 1.16; 95% CI, 1.01-1.32; P=.02).
Conclusions:
- Early term delivery is independently associated with an increased risk of pediatric cardiovascular morbidity.
- These findings suggest that deliveries occurring between 37 and 38 weeks gestation may have long-term cardiovascular health implications for offspring.
Objective:
To determine whether early term delivery (at 370/7-386/7 weeks of gestation) is associated with long-term pediatric cardiovascular morbidity of the offspring.
Study Design:
A population-based cohort analysis was performed including all term deliveries occurring between 1991 and 2014 at a single tertiary medical center. Gestational age at delivery was subdivided into early term (370/7-386/7), full term (390/7-406/7), late term (410/7-416/7) and post term (≥420/7) delivery. Hospitalizations of children up to the age of 18 years involving cardiovascular morbidity were evaluated, including structural valvular disease, hypertension, arrhythmias, rheumatic fever, ischemic heart disease, pulmonary heart disease, perimyoendocarditis, congestive heart failure, and others. Kaplan-Meier survival curves were used to compare cumulative hospitalization incidence between groups. A multivariable Weibull parametric model was used to control for confounders.
Results:
During the study period, 223 242 term singleton deliveries met the inclusion criteria. Of them, 24% (n = 53 501) occurred at early term. Hospitalizations involving cardiovascular morbidity were significantly more common in children delivered at early term (0.7%) as compared with those born at full (0.6%), late (0.6%), or post term (0.5%; P = .01). The survival curve demonstrated a significantly higher cumulative incidence of cardiovascular-related hospitalizations in the early term group (log-rank P <.001). In the Weibull model, early term delivery was found to be an independent risk factor for cardiovascular-related hospitalization as compared with full term delivery (adjusted HR, 1.16; 95% CI, 1.01-1.32; P = .02).
Conclusion:
Early term delivery is independently associated with pediatric cardiovascular morbidity of the offspring as compared with offspring born at full term.
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