Morbidity and mortality of advanced gestational age: post-term or postmature

Area of Science:

• Neonatology
• Perinatal Medicine
• Pediatric Critical Care

Background:

• Post-term infants are traditionally associated with risks of uteroplacental insufficiency and postmaturity syndrome.
• Intrauterine growth retardation (IUGR) is a known risk factor for adverse neonatal outcomes.
• The specific risks for normally grown post-term infants require further elucidation.

Purpose of the Study:

• To investigate whether morbidity and mortality linked to uteroplacental insufficiency are exclusive to post-term infants diagnosed with postmaturity syndrome.
• To assess the impact of intrauterine growth retardation (IUGR) on neonatal outcomes in post-term infants.
• To evaluate the developmental outcomes and neonatal complications in post-term infants based on their growth status.

Main Methods:

• A 6-year retrospective review of 53 post-term infants admitted to the neonatal intensive care unit (NICU).
• Objective identification of IUGR using the ponderal index (PI).
• Comparison of morbidity, mortality, and developmental outcomes between normally grown and malnourished post-term infants.

Main Results:

• All neonatal deaths occurred in large, appropriately grown infants and were associated with anoxic encephalopathy.
• Morbidity was equally distributed among normally grown and malnourished post-term infants.
• Developmental outcomes were similar between the two groups, and neonatal complications occurred even without recognizable fetal malnutrition.

Conclusions:

• The post-term infant population, irrespective of growth status, should be considered at risk for neonatal complications.
• Morbidity and mortality are not confined solely to post-term infants with signs of fetal malnutrition.
• Neonatal intensive care unit (NICU) admission for post-term infants warrants careful evaluation for potential complications, regardless of perceived fetal growth.