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Outcomes of Medically Indicated Preterm Births Differ by Indication.

Michelle J Wang1, Spencer G Kuper1, Robin Steele1

  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, The University of Alabama at Birmingham, Birmingham, Alabama.

American Journal of Perinatology
|December 30, 2017
PubMed
Summary
This summary is machine-generated.

Preterm birth outcomes worsen when delivery is indicated by fetal or obstetric issues rather than maternal conditions. This highlights the need for tailored counseling based on delivery reasons.

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Area of Science:

  • Neonatalogy
  • Obstetrics
  • Perinatology

Background:

  • Preterm birth (PTB) is a significant concern in neonatal care.
  • Delivery indications can influence neonatal outcomes.
  • Understanding these differences is crucial for improved patient management.

Purpose of the Study:

  • To investigate if the reason for delivery modifies preterm birth outcomes.
  • To compare neonatal outcomes based on maternal versus fetal/obstetric indications for delivery.

Main Methods:

  • Retrospective cohort study of singletons delivered between 23 to 34 weeks gestation.
  • Maternal indications included preeclampsia; fetal/obstetric indications included growth restriction, nonreassuring fetal status, and vaginal bleeding.
  • Primary outcome was a composite of neonatal death and major morbidities; logistic regression adjusted for confounders.

Main Results:

  • Women delivered for fetal/obstetric indications (25.2%) had a higher risk of the composite neonatal outcome compared to those delivered for maternal indications (74.8%) (aOR 1.9, 95% CI 1.13-3.21).
  • Increased risk of acidemia at birth was observed in the fetal/obstetric group (aOR 4.2, 95% CI 1.89-9.55).

Conclusions:

  • Preterm infants delivered for fetal/obstetric indications experience poorer outcomes than those delivered for maternal indications.
  • Further research is warranted to personalize counseling based on the specific indication for delivery.