Abstract:
Background: Prematurity is one of the leading causes of morbidity and mortality among newborns.
The incidence of preterm deliveries especially the late preterm births have unfortunately gone up in
the last decade. Late preterm births are associated with increased neonatal complications compared to
term births. This study makes an effort to find out the relevant maternal and fetal factors associated
with late preterm births. This study also assesses the maternal and neonatal outcomes associated with
late preterm births.
Methods: This prospective observational study was conducted at Maternal and Child Health Unit of
Shri B M Patil Medical College Hospital Vijayapur, Karnataka over a period of 1 year. 200 late
preterm births and 200 term births were enrolled in the study. During the study period, all neonates
delivered in the hospital were divided into two groups as late preterm group and term group. Maternal
and neonatal data was collected in predefined structured proforma.
Results: The mother's mean age in the late preterm group was 24.34 ± 4.07 years, and among the term
group was 25.24 ± 4.54 years, which was not statistically significant (P=0.857). The obstetric risk
factors observed for late preterm births were inadequate antenatal care (39%), premature rupture of
membranes (31%), hypertensive disease of pregnancy (24.5%), previous preterm delivery (21%), and
maternal anemia (13%). When two or more factors were found, late preterm labor incidence was
32.6% in this study. 14.5% late preterm's needed resuscitation (P=0.003), 45% late preterm neonates
had difficulty establishing feeding at birth (P<0.001), 34% late preterm’s had respiratory distress at
birth (P<0.001), 12% had hypoxic-ischemic encephalopathy (Stage 2/3) (0.003), 35% had early-onset
sepsis (P<0.001), 28% had jaundice (P<0.001), 24% had hypoglycemia (P<0.001), 41% had
hypothermia (P<0.001), 13.5% had HSPDA (P<0.006). The duration of hospital stay was significantly
more in late preterm neonates (8.7 ± 1.6 days) as compared to term neonates (3.9 ± 1.1 days) with a p value of <0.05. Most important is the mortality, which was significantly more among late preterm
neonates (18%) than term neonates (6%) with a p-value of 0.011.
Conclusion: Maternal risk factors such as preterm premature rupture of membrane, inadequate
antenatal care, hypertensive disorders of pregnancy, and maternal anemia were associated with late
preterm births. Since late preterm birth is an independent risk factor for neonatal morbidity and
mortality compared to term neonates, knowing maternal and perinatal risk factors is essential. Early
identification and management of these risk factors reduces the neonatal morbidities and mortalities.
