title: Early-term deliveries as an independent risk factor for long-term respiratory morbidity of the offspring.
abstract: Newborns exhibit the lowest immediate respiratory morbidity rates when born following 39 completed weeks of gestation. We sought to determine whether early-term delivery (37-38 + 6 weeks' gestation) impacts on long-term pediatric respiratory morbidity.
  
  
  
  In this population-based prospective cohort analysis, all term singleton deliveries occurring between 1991 and 2013 at a single tertiary medical center were included. Gestational age upon delivery was sub-divided into: early (37-38 + 6 weeks' gestation), full (39-40 + 6 weeks' gestation), late (41-41 + 6 weeks' gestation), and post-term (>42 weeks) deliveries. The incidence of long-term hospitalizations (up to the age of 18 years) of the offspring due to a set of predefined respiratory morbidities was evaluated. Survival curves were used to compare cumulative morbidity incidence. A Cox hazards regression model was used to control for confounders.
  
  
  
  During the study period, 229,142 term deliveries met the inclusion criteria. Of those, 24% (n = 55,202) occurred at early term. Hospitalizations up to the age of 18 years, as a result of complications in the respiratory system were significantly more common in the early-term group as compared with full and late-term delivery groups. In the Cox regression model, while controlling for multiple confounders, early-term delivery exhibited an independent association with long-term respiratory morbidity (adjusted HR = 1.24, CI 1.19-1.29, P < 0.001).
  
  
  
  Deliveries occurring at early term are associated with higher rates of pediatric respiratory hospitalizations compared with full and late-term deliveries. Pediatr Pulmonol. 2017;52:198-204. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel.
authors.forename: Asnat
authors.initials: A
authors.lastname: Walfisch
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Beharier
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Wainstock
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Sergienko
authors.affiliation: Department of Neonatology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Daniella
authors.initials: D
authors.lastname: Landau
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology; D001988:Bronchiolitis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007251:Influenza, Human / Q000453:epidemiology; D008137:Longitudinal Studies; D009017:Morbidity; D011014:Pneumonia / Q000453:epidemiology; D011247:Pregnancy; D011273:Pregnancy, Prolonged / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012307:Risk Factors; D047929:Term Birth; D055815:Young Adult
keywords: follow-up; full-term pregnancy; long-term; pediatric morbidity; term gestation