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Neonatal complications of postterm gestation
1Department of Pediatrics, University of California, San Diego 92103.
Insights
Postterm infants, born after 42 weeks, face higher risks of birth complications like perinatal asphyxia. However, careful obstetric management can prevent most neonatal issues in these newborns.
Area of Science:
- Neonatalogy
- Obstetrics
- Perinatology
Background:
- Postterm gestation infants constitute approximately 10% of newborns.
- These infants exhibit a higher incidence of perinatal and neonatal complications compared to term infants.
- While most postterm infants appear normal, some show signs of dysmaturity due to fetal wasting.
Purpose of the Study:
- To review the complications and outcomes associated with postterm gestation.
- To highlight the increased risks of perinatal asphyxia and other neonatal problems in postterm infants.
- To emphasize the role of obstetric management in preventing adverse outcomes.
Main Methods:
- Literature review of postterm infant complications.
- Analysis of incidence and risk factors for neonatal problems.
- Examination of long-term developmental and growth outcomes.
Main Results:
- Postterm infants are at increased risk for fetal distress, perinatal asphyxia, hypoxic encephalopathy, seizures, meconium aspiration syndrome, birth trauma, and polycythemia.
- The incidence of dysmaturity increases with prolonged postterm gestation.
- Anencephaly is associated with postterm gestation.
- Intellectual development is typically normal unless affected by perinatal asphyxia or severe neonatal issues.
- Long-term somatic growth is generally normal.
Conclusions:
- Postterm infants face significant risks, primarily related to perinatal asphyxia.
- Careful obstetric management is crucial for preventing most neonatal problems in postterm infants.
- While dysmaturity can occur, long-term growth and development are usually normal in the absence of severe perinatal complications.
Abstract:
Postterm gestation infants represent about 10% of the newborn population and, as compared to term gestation infants, have an increased incidence of perinatal and neonatal problems. Most postterm infants are normal appearing, although changes in the skin and a loss of subcutaneous fat occur in some. A smaller number experience the onset of fetal wasting late in gestation and appear dysmature (postmature) at birth. The incidence of infants with dysmaturity increases as postterm gestation continues; however, the prevalence of dysmaturity is greater in term infants. The most significant neonatal problems in the postterm gestation infant are the result of fetal distress and perinatal asphyxia. Those infants affected most severely may have hypoxic encephalopathy, seizures and meconium aspiration syndrome. Other problems are birth trauma (due to the large size of some postterm infants) and polycythemia. Anencephaly is associated with postterm gestation. The later intellectual development of postterm gestation infants appears normal except for those with perinatal asphyxia or severe neonatal problems. The long-term somatic growth is normal, even in dysmature-appearing infants. Postterm infants are at increased risk for perinatal asphyxia; however, with careful obstetric management, most neonatal problems can be prevented.