후기 조산아와 산모의 임상적 특징: 단일기관 자료
Neonatal and Maternal Clinical Characteristics of Late Preterm Births: Single Center Data
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Department of Pediatrics, Chonnam University Medical School, Gwangju, Korea2 Purpose: Recently, the number of late preterm infants are increasing, and they are prone to have many clinical problems. The purpose of this study is to emphasize the importance of perinatal care for the late preterm infants and their mothers. Methods: Total admitted numbers of late preterm infants were 547 (from 464 mothers) and of term infants were 1,514 (from 1,470 mothers) in NICU, at Chonnam National University Hospital January 2014~December 2015. Maternal and neonatal mortality rate were calculated in the total admitted numbers. Exclusion criteria were death or transfer during admission, congenital anomaly, and etc. The enrolled numbers of late preterm infants were 493 (from 418 mothers) and of term infants were 1,167 (from 1,123 mothers). Retrospective chart review was conducted. In mothers, demographics, underlying illness, and obstetric complication, and in newborns, demographics, hospital days and morbidity were compared between late preterm group and term group. Results: Maternal mortality rate was not different. However, neonatal mortality rate was higher in late preterm infants. In mothers of late preterm group, there was no difference in demographic characteristics, but the rates of autoimmune disease and obstetric complication were higher. In infants of late preterm group, body size was smaller, artificial conception and C-section rate were higher, and one and five-minute Apgar scores were lower, and hospital duration was longer. And the incidence of respiratory distress, transient tachypena of newborn, intraventricular hemorrhage and metabolic abnormalities were higher, but the incidence of meconium aspiration syndrome was lower compare to the term infant group. Conclusion: Maternal mortality was not different. However, neonatal mortality was higher in late preterm infants. In late preterm group, the mothers had higher rate of autoimmune disease and obstetric complication, and the infants had higher morbidity compare to the term group. When the obstetrician decides on delivery time in high risk pregnancy, maternal medical condition and neonatal outcome should be considered.
Abstract
Department of Pediatrics, Chonnam University Medical School, Gwangju, Korea2 Purpose: Recently, the number of late preterm infants are increasing, and they are prone to have many clinical problems. The purpose of this study is to emphasize the importance of perinatal care for the late preterm infants and their mothers. Methods: Total admitted numbers of late preterm infants were 547 (from 464 mothers) and of term infants were 1,514 (from 1,470 mothers) in NICU, at Chonnam National University Hospital January 2014~December 2015. Maternal and neonatal mortality rate were calculated in the total admitted numbers. Exclusion criteria were death or transfer during admission, congenital anomaly, and etc. The enrolled numbers of late preterm infants were 493 (from 418 mothers) and of term infants were 1,167 (from 1,123 mothers). Retrospective chart review was conducted. In mothers, demographics, underlying illness, and obstetric complication, and in newborns, demographics, hospital days and morbidity were compared between late preterm group and term group. Results: Maternal mortality rate was not different. However, neonatal mortality rate was higher in late preterm infants. In mothers of late preterm group, there was no difference in demographic characteristics, but the rates of autoimmune disease and obstetric complication were higher. In infants of late preterm group, body size was smaller, artificial conception and C-section rate were higher, and one and five-minute Apgar scores were lower, and hospital duration was longer. And the incidence of respiratory distress, transient tachypena of newborn, intraventricular hemorrhage and metabolic abnormalities were higher, but the incidence of meconium aspiration syndrome was lower compare to the term infant group. Conclusion: Maternal mortality was not different. However, neonatal mortality was higher in late preterm infants. In late preterm group, the mothers had higher rate of autoimmune disease and obstetric complication, and the infants had higher morbidity compare to the term group. When the obstetrician decides on delivery time in high risk pregnancy, maternal medical condition and neonatal outcome should be considered.
참고문헌 (26)
- Berard A, "Study of the costs and morbidities of late-preterm birth", Arch Dis Child Fetal Neonatal Ed, 97, pp.F329~F334 (2012)[DOI]
- "Birth Statitics"[URL]
- Davidoff MJ, "Changes in the gestational age distribution among US singleton births: impact on rates of late preterm birth, 1992 to 2002", Semin Perinatol, 30, pp.8~15 (2006)[DOI]
- Dobak WJ, "Late preterm gestation: physiology of labor and implications for delivery", Clin Perinatol, 33, pp.765~776 (2006)[DOI]
- Engle WA, ""Late-preterm" infants: a population at risk", Pediatrics, 120, pp.1390~1401 (2007)[DOI]
- Escobar GJ, "Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions", Semin Perinatol, 30, pp.28~33 (2006)[DOI]
- Hunt CE, "Ontogeny of autonomic regulation in late preterm infants born at 34-37 weeks postmenstrual age", Semin Perinatol, 30, pp.73~76 (2006)[DOI]
- Jahromi BN, "Pregnancy outcome at maternal age 40 and older", Taiwan J Obstet Gynecol, 47, pp.318~321 (2008)[DOI]
- Jorgensen AM, "Late Preterm Infants: Clinical Complications and Risk: Part Two of a Two-Part Series", Nurs Womens Health, 12, pp.316~330 (2008)[DOI]
- Joseph KS, "Theory of obstetrics: an epidemiologic framework for justifying medically indicated early delivery", BMC Pregnancy Childbirth, 7, pp.4~18 (2007)[DOI]
- Laptook A, "Cold stress and hypoglycemia in the late preterm ("near-term") infant: impact on nursery of admission", Semin Perinatol, 30, pp.24~27 (2006)[DOI]
- 임달오, "우리나라 대도시의 지역별 후기조기분만 발생에 관한 연구: 2008-2012", 보건의료산업학회지, 8(3), pp.147~155 (2014), 보건의료산업학회
- Mathews TJ, "Infant mortality statistics from the 2004 period linked birth", infant death data set, 2007, pp.55, 1~32
- Morse SB, "Early school-age outcomes of late preterm infants", Pediatrics, 123, pp.e622~e629 (2009)[DOI]
- 나지윤, "후기 조산아들의 단기 임상적 결과", Clinical and Experimental Pediatrics, 52(3), pp.303~309 (2009), 대한소아청소년과학회
- Park SH, "Incidence of late preterm in Korean singleton birth", J Reprod Med, 24, pp.110~116 (2011)
- Raju TN, "The problem of late-preterm (near-term) births: a workshop summary", Pediatr Res, 60, pp.775~776 (2006)[DOI]
- Raju TN, "Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development", Pediatrics, 118, pp.1207~1214 (2006)[DOI]
- Roberton NR, "Early neonatal hypocalcaemia", Arch Dis child, 50, pp.604~609 (1975)[DOI]
- Shapiro-Mendoza CK, "Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk", Pediatrics, 121, pp.e223~e232 (2008)[DOI]
- Stoll BJ, "Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network", Pediatrics, 126, pp.443~456 (2010)[DOI]
- Sunehag AL, "Glucose extremes in newborn infants", Clin Perinatol, 29, pp.245~260 (2002)[DOI]
- Symonds ME, "Endocrine and nutritional regulation of fetal adipose tissue development", J Endocrinol, 179, pp.293~299 (2003)[DOI]
- Tomashek KM, "Early discharge among late preterm and term newborns and risk of neonatal morbidity", Semin Perinatol, 30, pp.61~68 (2006)[DOI]
- Wang ML, "Clinical outcomes of near-term infants", Pediatrics, 114, pp.372~376 (2004)[DOI]
- Zayek MM, "Acidemia versus hypercapnia and risk for severe intraventricular hemorrhage", Am J Perinatol, 31, pp.345~352 (2014)