title: [Neonatal morbidity in early-term newborns].
abstract: BACKGROUND
  In the last decades has increased significantly The birth of children from 37 to 38 weeks of gestation, a period called early term, has significantly increased in the past twenty years or so, parallel to the increase in induced deliveries and the cesarean rate.
  
  
  METHODS
  Retrospective cohorts population study, which included those babies born between 37 and 41 weeks of gestation in the period 1992-2011 (n=35.539). This population was divided into two cohorts, early term newborn (RNTP) of 37-38 weeks (n=11,318), and full term newborn (RNTC), of 39-41 weeks of gestation (n=24,221). The rates of cesarean section, neonatal unit admission, respiratory morbidity, apnea and need for assisted ventilation, hyperbilirubinemia requiring phototherapy, hypoglycemia, seizures, hypoxic-ischemia encephalopathy, need for parenteral nutrition and early sepsis were all reviewed.
  
  
  RESULTS
  There was a progressive increase in the number of caesarean sections throughout the period studied (from 30.9% to 40.3%). The cesarean section rate was higher in RNTP than in the RNTC (38.3% vs 31.3%, P<.0001). On comparing the two groups, significant differences were found in the rate of admission to neonatal unit, 9.1% vs 3.5% (P<.0001); respiratory morbidity (hyaline membrane 0.14% vs 0.007% [P<.0001], transient tachypnea 1.71% vs 0.45% [P<.0001], mechanical ventilation 0.2% vs 0.07% [P<.009], continuous positive airway pressure 0.11% vs 0.01% [P<.0001]), phototherapy 0.29% vs 0.07% (P<.0001), hypoglycemia 0.54% vs 0.11% (P<.0001), parenteral nutrition 0.16% vs 0.04% (P<.0001). There were no significant differences in the rate of early sepsis, pneumothorax, aspiration syndromes, seizures and hypoxic-ischemic encephalopathy.
  
  
  CONCLUSIONS
  In our environment, there is a significant number of RNTP, which have a significantly higher morbidity than newborns RNTC registered. After individualizing each case, it is essential not end a pregnancy before 39 weeks of gestation, except for maternal, placental or fetal conditions indicating that continuing the pregnancy may increase the risk for the fetus and/or the mother.
authors.affiliation: SCIAS, Hospital de Barcelona, Barcelona, España. Electronic address: neonatos@sciashdb.com.
authors.forename: S
authors.initials: S
authors.lastname: Martínez-Nadal
authors.affiliation: SCIAS, Hospital de Barcelona, Barcelona, España.
authors.forename: X
authors.initials: X
authors.lastname: Demestre
authors.affiliation: SCIAS, Hospital de Barcelona, Barcelona, España.
authors.forename: F
authors.initials: F
authors.lastname: Raspall
authors.affiliation: SCIAS, Hospital de Barcelona, Barcelona, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Alvarez
authors.affiliation: SCIAS, Hospital de Barcelona, Barcelona, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Elizari
authors.affiliation: SCIAS, Hospital de Barcelona, Barcelona, España.
authors.forename: C
authors.initials: C
authors.lastname: Vila
authors.affiliation: SCIAS, Hospital de Barcelona, Barcelona, España.
authors.forename: P
authors.initials: P
authors.lastname: Sala
mesh_terms: D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D012189:Retrospective Studies
keywords: Cesárea electiva; Early term babies; Elective cesarean section; Fetal lung maturity; Madurez pulmonar fetal; Morbilidad neonatal; Neonatal morbidity; Neurodesarrollo; Neurodevelopment; Recién nacido a término; Recién nacido a término precoz; Term babies