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Updated: May 3, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Short-Term Outcomes of Early-Term Versus Full-Term and Late-Term Neonates: A Systematic Review and Meta-Analysis

Siddarth Venkateswaran1, Junye George Chen1, Chescia Yi-Xin Lim1

  • 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

BJOG : an International Journal of Obstetrics and Gynaecology
|September 4, 2025
PubMed

Insights

Early-term births increase neonatal risks for respiratory distress and other complications. Enhanced perinatal care is crucial for this vulnerable group.

Area of Science:

  • Neonatal Health
  • Perinatal Medicine
  • Public Health

Background:

  • Early-term births (37-38 weeks) represent a significant portion of global births, yet their neonatal impact is often underestimated.
  • Existing research has not fully elucidated the short-term neonatal outcomes associated with early-term deliveries compared to full-term or late-term births.

Purpose of the Study:

  • To systematically review and synthesize global evidence on short-term neonatal outcomes comparing early-term with full-/late-term births.
  • To specifically analyze outcomes in low- and middle-income countries (LMICs).

Main Methods:

  • A comprehensive search of PubMed and Embase databases was conducted up to March 13, 2025.
  • Meta-analyses of 35 medium-to-high quality studies (over 13 million neonates) were performed using random-effects models, adhering to PRISMA guidelines.
  • Studies involving multiple pregnancies were excluded.

Main Results:

  • Early-term neonates exhibited significantly higher risks of respiratory distress syndrome (OR 2.85), transient tachypnoea of the newborn (OR 2.00), and composite respiratory morbidities (OR 1.75).
  • In LMICs, the risk of respiratory distress syndrome in early-term neonates was even more pronounced (OR 4.77), though data generalizability was limited.
  • Increased need for mechanical ventilation (OR 2.08), CPAP (OR 2.41), and oxygen therapy (OR 1.88) was observed in early-term infants.

Conclusions:

  • Early-term birth is associated with increased short-term adverse neonatal outcomes, particularly respiratory complications.
  • Heightened vigilance in perinatal management strategies is essential to improve outcomes for neonates born early-term.
  • Further research focusing on LMICs is needed to fully understand and address the risks in these settings.
Abstract

Keywords:
caesarean sectionlow‐ and middle‐income countriesneonatal mortalityneonatesoperative deliveriesrespiratory distress syndrome

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