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Short-term outcomes in early term infants (born at 37 or 38 weeks): a retrospective investigation
Tsubasa Kitamura1, Kyosuke Tabata2,3, Yayoi Murano2,3
1Division of Obstetrics and Gynecology, Tokyo Metropolitan Toshima Hospital, Tokyo, Japan.
Insights
Early term infants born at 37 or 38 weeks gestation face higher risks of hospitalization, apnea, and hypoglycemia. These findings highlight the need for careful clinical consideration of early term births.
Area of Science:
- Neonatal Medicine
- Maternal-Fetal Medicine
- Pediatric Outcomes Research
Background:
- The definition of 'early term' infants (37-38 weeks gestation) necessitates outcome assessment.
- Early term infants represent a significant proportion of newborns, impacting clinical practice.
- Understanding early term infant outcomes is crucial for managing potential complications.
Purpose of the Study:
- To investigate the short-term clinical outcomes of early term infants.
- To compare outcomes between infants born at 37 weeks and 38 weeks gestation.
- To inform clinical practice and strategies regarding elective cesarean sections.
Main Methods:
- Observational study utilizing medical records from Tokyo Metropolitan Toshima Hospital.
- Analysis of data from 4,669 eligible term infants.
- Logistic regression analysis to determine odds ratios for various complications.
Main Results:
- Early term infants (37-38 weeks) showed increased odds of hospitalization (1.56), apnea (2.23), and hypoglycemia (3.13).
- Infants born at 37 weeks had higher odds of hospitalization (2.07) and hypoglycemia (4.11) compared to those born at 38 weeks.
- Gestational age at 38 weeks was associated with lower odds of hospitalization (1.40) and hypoglycemia (2.78) than 37 weeks.
Conclusions:
- Early term infants experience a more complicated clinical course than previously recognized.
- Findings suggest that elective cesarean sections may be optimally planned at 38 weeks gestation.
- Clinical awareness of potential complications in early term infants is essential.
Introduction:
Recently, researchers have introduced the concept of 'early term' infants, defined as infants born at 37 or 38 weeks of gestation, and their outcome has been discussed. Although the complications experienced by early term are less severe than those in preterm infants, this group accounts for a much larger proportion of newborns, making the assessment of outcomes important in clinical practice.
Methods:
This observational study of term infants born at Tokyo Metropolitan Toshima Hospital aimed to understand the short-term outcomes in early term infants. Data extracted from the medical records were analyzed.
Results:
Among 4,669 eligible participants, 463 (9.9%) were born at 37 weeks and 1,270 (27.2%) were born at 38 weeks. The remaining 2,936 infants were born after 39 weeks of gestation. Logistic regression analysis showed higher odds ratio of hospitalization (1.56, 95% CI: 1.37-1.79, p < 0.05), apnea (2.23, 95%CI: 1.08-4.60, p < 0.05), and hypoglycemia (3.13, 95%CI: 1.95-5.03, p < 0.05) in early term infants. In detail, infants born at 37 weeks of gestational age had higher odds ratio for hospitalization (2.07, 95%CI: 1.68-2.35, p < 0.05) and hypoglycemia (4.11, 95%CI 2.22-7.60, p < 0.05) than infants born at 38 weeks of gestational age (1.40, 95%CI: 1.20-1.62, p < 0.05, and 2.78, 95%CI: 1.66-4.67, p < 0.0 respectively).
Discussion:
This study revealed complicated clinical course in early term infants, and represents one of the largest contributions to understanding the outcomes of early term infants, and could help to determine strategies for elective cesarean section. According to this result, elective cesarean sections would be better planned at 38 weeks of gestational age. Moreover, in clinical practice, it is important to be aware of the complicated clinical course in early term infants.
