title: Risks associated with delivering infants 2 to 6 weeks before term--a review of recent data.
abstract: BACKGROUND
  There is an increasing trend towards delivery before 39 weeks of gestational age. The short- and long-term effects of early delivery on the infant have only recently received scientific attention.
  
  
  METHODS
  Selective review of the literature
  
  
  RESULTS
  Delivery at any time before 39 weeks is associated with significantly higher infant mortality and with an increase of the risk of impairments after birth from 8% to 11%. The increase in risks of various kinds is disproportionately more pronounced the earlier the child is delivered. For example, the risk of needing respiratory support or artificial ventilation after birth increases from 0.3% with delivery at 39-41 weeks of gestational age to 1.4% at 37 weeks and 10% at 35 weeks, while the risk of death or neurological complications increases from 0.15% at 39-41 weeks of gestation to 0.66% at 35 weeks. Delivery at 34.0 to 36.6 weeks of gestation also has long-term effects. Compared to delivery at term, the frequency of cerebral palsy rises threefold, from 0.14% to 0.43%; the risk of death in early adulthood rises by about half, from 0.046 to 0.065%; and the risk of dependence on government benefits in early adulthood also rises by about half, from 1.7% to 2.5%.
  
  
  CONCLUSIONS
  Studies from the USA have shown that the number of medically indicated deliveries before 39 weeks can be lowered by 70% to 80% through consistently applied measures for quality improvement. If similar results could be achieved in Germany, the iatrogenic complications of delivery would become less common in this country as well.
authors.affiliation: Department of Neonatology, University Children's Hospital Tübingen, Germany. christian-f.poets@med.uni-tuebingen.de
authors.forename: Christian F
authors.initials: CF
authors.lastname: Poets
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
authors.forename: Klaus
authors.initials: K
authors.lastname: Vetter
mesh_terms: D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate