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Long-term pediatric hematological morbidity of the early-term newborn
Gil Gutvirtz1, Tamar Wainstock2, Eyal Sheiner3
1Department of Obstetrics and Gynecology, Soroka University Medical Center (SUMC), Ben-Gurion University of the Negev, 151 Izak Rager Ave., 84101, Beer-Sheva, Israel. Giltzik@gmail.com.
Insights
Children born at early term face higher risks for long-term hematological morbidity. This study found early-term delivery is an independent risk factor for conditions like anemia and immunodeficiency disorders in children.
Area of Science:
- Pediatrics
- Hematology
- Obstetrics
Background:
- Early term birth (37 0/7 to 38 6/7 weeks' gestation) is linked to increased risks for various long-term morbidities.
- Previous research highlighted risks for respiratory, cardiovascular, neurological, and developmental issues, as well as short-term adverse outcomes like perinatal mortality.
Purpose of the Study:
- To evaluate the long-term hematological morbidity associated with early-term delivery.
- To determine if early-term birth is an independent risk factor for hematological conditions in children up to 18 years of age.
Main Methods:
- A population-based cohort analysis of 223,242 term singleton deliveries.
- Evaluation of offspring hospitalizations up to 18 years for hematological morbidities, including anemias, immunodeficiencies, and coagulation disorders.
- Statistical analysis using Kaplan-Meier curves and Cox regression modeling.
Main Results:
- Hematological hospitalizations were significantly more frequent in early-term born children compared to those born at later gestational ages.
- Early-term delivery was identified as an independent risk factor for childhood hematological morbidity (adjusted hazard ratio 1.15).
- Kaplan-Meier analysis showed a significantly higher cumulative incidence of hematological-related hospitalizations in the early-term group.
Conclusions:
- Early-term delivery is independently associated with an increased risk of long-term hematological morbidity in offspring.
- Findings suggest a need for increased awareness and potential monitoring for hematological conditions in children born at early term.
Abstract:
Children born at early term (37 0/7 to 38 6/7 weeks' gestation) are at an increased risk for long-term respiratory, cardiovascular, neurological, and developmental morbidities as compared with children born at full term (39 0/7 to 40 6/7 weeks' gestation). In this population-based cohort analysis, we sought to evaluate the long-term hematological morbidity of early-term born children. The cohort consisted of 223,242 term singleton deliveries. Hospitalizations of the offspring up to 18 years of age involving hematological morbidity were evaluated, including hereditary and acquired anemias, immunodeficiency disorders, coagulation disorders, white blood cell disorders, cytopenias, polycythemia, and myelodysplastic syndrome. Hematological hospitalizations were significantly more common in children delivered at early term as compared with those born at later gestational ages. A Kaplan-Meier survival curve demonstrated a significantly higher cumulative incidence of hematological-related hospitalizations in the early-term born group (logrank p < 0.001). Using a Cox regression model, early-term delivery was found to be an independent risk factor for childhood hematological morbidity with an adjusted hazard ratio of 1.15 (95%CI 1.01-1.30, p=0.027).Conclusion: Early-term delivery appears to be independently associated with pediatric long-term hematological morbidity of the offspring. What is Known? • It has been shown that children born at early term are at increased risk for short-term adverse outcomes including perinatal mortality. • Early-term infants are also at increased risk for long-term morbidity, mainly respiratory. What is New? • Early-term delivery is also independently associated with long-term hematological morbidity of the offspring.
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