title: [Analysis of clinical characteristics and factors associated with short term outcomes in early term neonates].
abstract: Objective:To investigate the clinical characteristics of early term and full term neonates, and analyze the risk factors associated with short term outcomes in early term neonates.Method:Neonates with birth weight (BW) ≥2 500 g from year 2013 were analyzed retrospectively based on American Congress of Obstericians & Gynecologists (ACOG) latest definition of term infants. According to inclusion and exclusion criteria, early term (gestational age 37-38 weeks) and full term(gestational age 39-40 weeks) neonates were included, whose morbidity constituent proportion was analyzed by χ(2) test or Fisher accuracy test orttest or Wilcoxon test. Risk factors associated with short term outcomes in early term population were analyzed by Logistic regression analysis.Result:There were 3 002 discharged term infants being investigated, among whom 1 303 cases were included(768 males and 535 females), and 37, 38, 39 and 40 weeks' gestational age newborns were 160, 324, 450 and 369 respectively. Compared with full term neonates(n=819), early term neonates (n=484) had longer length of hospital stay (LOS)(6.0(5.0, 9.0)vs. 6.0(4.0, 8.0),Z=2.830,P=0.005), higher usage rate of intravenous antibiotics(86.4%(418/484)vs. 80.1%(656/819), χ(2)=8.009,P=0.005), higher assisted ventilation rate(9.5%(46/484)vs. 2.9%(24/819), χ(2)=25.528,P<0.01), higher pulmonary surfactant administration rate(4.3%(21/484)vs. 1.1%(9/819), χ(2)=14.006,P<0.01), as well as higher hypoglycemia incidence(3.9%(19/484)vs. 1.2%(10/819), χ(2)=10.226,P=0.001). There were no statistically significant differences in 1 min Apgar score (9(9, 10)vs. 9(9, 10),Z=0.860,P=0.390), 5 min Apgar score (10(9, 10)vs. 10(9, 10),Z=0.810,P=0.418), white blood cell count (15 (11, 21) ×10(9) /Lvs.15 (11, 22) ×10(9) /L,Z=0.880,P=0.379), hemoglobin count(180 (159, 205)vs. 182 (160, 204) g/L,Z=0.560,P=0.576), or platelet count(303(234, 372) ×10(9)/Lvs. 301(237, 391) ×10(9)/L,Z=0.550,P=0.584). BW between 2 500 g and 2 999 g(OR1.69, 95%CI: 1.10-2.62, χ(2) =5.614,P=0.018), wet lung(OR=2.61, 95%CI: 1.61-4.24, χ(2)=15.023,P=0.000)and pneumonia(OR1.88, 95%CI: 1.14-3.08, χ(2)=6.192,P=0.013) were risk factors in early term neonates' short term adverse outcomes.Conclusion:Early term newborns are still at their "immature" state, and respiratory disorders are major risk factors associated with short term outcomes. Hence, early delivery during 37-38 weeks should be avoided as possible as we can.
authors.affiliation: *Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China.
authors.forename: S S
authors.initials: SS
authors.lastname: Long
authors.forename: Q X
authors.initials: QX
authors.lastname: Tang
authors.forename: B X
authors.initials: BX
authors.lastname: Huang
authors.forename: B Y
authors.initials: BY
authors.lastname: Lin
authors.forename: L S
authors.initials: LS
authors.lastname: Wang
mesh_terms: D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D011663:Pulmonary Surfactants; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D011663:Pulmonary Surfactants
keywords: Prognosis; Risk factors; Term birth