title: Risk factors for serious morbidity in term nonanomalous neonates.
abstract: OBJECTIVE
  The purpose of this study was to identify ante- and intrapartum risk factors for serious morbidity in term nonanomalous neonates.
  
  
  METHODS
  We analyzed the first 5000 subjects within an ongoing prospective cohort study of consecutive term births from 2010-2012. The primary outcome was a composite of serious neonatal morbidity defined as ≥1 cases of hypoxic ischemic encephalopathy, meconium aspiration with pulmonary hypertension, requirement of hypothermia therapy, respiratory distress syndrome, seizures, sepsis or suspected sepsis, or death. We calculated odds ratios for the composite morbidity that is associated with ante- and intrapartum factors. Multivariable logistic regression was used to estimate adjusted odds ratios.
  
  
  RESULTS
  Of 5000 term nonanomalous births, 393 had the composite morbidity. Significant risk factors for morbidity were nulliparity, presence of meconium, first stage of labor >95th percentile, second stage of labor >95th percentile, pregestational diabetes mellitus, chronic hypertension, obesity, maternal intrapartum fever, and cesarean delivery. In contrast, induction of labor and gestational age ≥41 weeks were not associated with significant morbidity.
  
  
  CONCLUSIONS
  We identified several significant risk factors for serious morbidity in term nonanomalous neonates. Clinicians may use these risk factors to help anticipate the potential need for additional neonatal support at delivery.
authors: Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO. Electronic address: spainj@wudosis.wustl.edu.
authors: Janine E
authors: JE
authors: Spain
authors: Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO.
authors: Methodius G
authors: MG
authors: Tuuli
authors: Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO.
authors: George A
authors: GA
authors: Macones
authors: Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO.
authors: Kimberly A
authors: KA
authors: Roehl
authors: Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO.
authors: Anthony O
authors: AO
authors: Odibo
authors: Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO.
authors: Alison G
authors: AG
authors: Cahill
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D009017:Morbidity; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D047929:Term Birth; D055815:Young Adult
keywords: neonatal morbidity; risk factor; term neonate