Neonatal Outcomes Following Preterm Birth Between 28 and 36 Weeks' Gestation in Vietnam: A Cohort Study

Preterm birth leads to adverse neonatal outcomes. Data on neonatal outcomes in middle-income settings like Vietnam are lacking.

Describe preterm neonatal outcomes in Vietnam.

Retrospective cohort study including all live singleton births at 28-36 weeks' gestation in Vietnam from June 2019 to June 2020. Outcomes included neonatal morbidity and mortality and were examined by labour onset and gestational age groups. Logistic regression was used to estimate the odds of neonatal morbidity and mortality following planned birth (labour induction and prelabour caesarean) relative to spontaneous birth.

Among 5374 live singleton preterm births, 663 (12.4%) occurred between 28 and 31 weeks, 824 (15.3%) between 32 and 33 weeks and 3887 (72.3%) between 34 and 36 weeks; 2765 (51.5%) births followed spontaneous labour and 2616 (48.5%) were planned births. Mortality rates decreased with increasing gestational age. More than 90% of neonates born at 28-33 weeks had morbidity, with the rate of morbidity decreasing from 34 weeks. The odds of mortality were no different following labour induction (aOR 1.22, 95% CI, 0.72-2.09) or prelabour caesarean (aOR 1.04, 95% CI, 0.63-1.73) compared with spontaneous labour. The odds of morbidity were higher among pregnancies following labour induction (aOR 1.53, 95% CI, 1.31-1.80) and prelabour caesarean section (aOR 2.14, 95% CI, 1.84-2.50) than spontaneous labour. Among planned preterm births < 35 weeks, antenatal corticosteroids were associated with higher morbidity (90.7% vs. 74.3%, p < 0.001) and lower mortality rates (2.5% vs. 5.1%, p = 0.022).

Preterm neonates born before 34 weeks are at particularly high likelihood of morbidity and mortality, with planned preterm birth associated with a higher rate of morbidity.