Adverse perinatal outcomes in 665,244 term and post-term deliveries-a Norwegian population-based study

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Perinatal Epidemiology

Background:

• Gestational age at delivery significantly impacts perinatal outcomes.
• Understanding risks associated with early-term deliveries is crucial for optimizing maternal and infant health.
• Spontaneous labor onset in different term categories requires specific risk assessment.

Purpose of the Study:

• To evaluate the prevalence and risk of adverse perinatal outcomes across early-term, full-term, late-term, and post-term deliveries.
• To compare these outcomes in spontaneous labor onset deliveries.
• To inform clinical management strategies for term deliveries.

Main Methods:

• Population-based cohort study using Norwegian Medical Birth Registry and Statistics Norway data (1999-2014).
• Included 665,244 singleton live births with cephalic presentation and spontaneous labor onset.
• Multivariable regression analysis adjusted for maternal and obstetric factors.

Main Results:

• Early-term deliveries (37-38 weeks) showed increased risks for neonatal jaundice, polyhydramnios, small for gestational age (SGA), respiratory support, and NICU admission.
• Increased prevalence of low 5-min Apgar scores and newborn antibiotic treatment observed in early-term and post-term infants.
• Oligohydramnios, meconium-stained amniotic fluid, and birth injuries increased with advancing gestational age.

Conclusions:

• Early-term deliveries are associated with greater perinatal morbidity compared to later term deliveries.
• Findings highlight the need for cautious management of low-risk early-term deliveries.
• Gestational age is a critical factor in perinatal outcome prediction.