title: Early term births: considerations in management.
abstract: The frequency of early term birth varies depending on patient, provider, and system characteristics. Early term deliveries are associated with suboptimal neonatal outcomes without evidence of maternal benefit. Some early term births are either unavoidable or absolutely indicated for maternal and/or fetal benefit in the setting of medical or obstetric risks. Demonstrated fetal lung maturity before early term birth reduces the risk of respiratory and other morbidities relative to gestational age-matched counterparts but may not reduce the risks to the low levels at 39 to 40 weeks. For some risk situations, it remains controversial whether earlier delivery is beneficial. The assessment of the provider and patient’s desires should direct care. In the absence of any obstetric or medical risks, early term delivery should be avoided. A simple intervention that includes administrative support, review of indications, and feedback to providers can dramatically reduce the frequency of early term births over time.
authors.affiliation: Maternal and Fetal Medicine Division, UAB Department of Obstetrics & Gynecology, 1700 6th Avenue South, Women & Infants Center, Room 10270, Birmingham, AL 35233, USA. luisa.wetta@obgyn.uab.edu
authors.forename: Luisa
authors.initials: L
authors.lastname: Wetta
authors.forename: Alan T N
authors.initials: AT
authors.lastname: Tita
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data; D003657:Decision Making; D005260:Female; D005325:Fetal Organ Maturity; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology / Q000628:therapy*; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology