Geç Preterm Doğum Olgularında Erken Neonatal Sonuçlar
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2013
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info:eu-repo/semantics/openAccess
Özet
Amaç: Preterm doğumlar son zamanlarda birçok ülkede artış göstermiştir. Fetal akciğerin gelişmiş olmasına rağmen, 34. gebelik haftasından sonra bile ciddi yenidoğan morbiditesi meydana gelebilir. Bu çalışmanın amacı, geç preterm doğum olgularında neonatal morbidite ve mortaliteyi araştırmaktır. Planlama: Retrospektif Ortam: Düzce Üniversitesi Tıp Fakültesi, Kadın Hastalıkları-Doğum ve Pediatri Kliniği Hastalar: 340/7-366/7 gebelik haftasında doğum yapan 291 gebe kadın ve yenidoğanlar incelendi. Girişim: Çalışmaya dahil edilen olgular PPROM varlığı ya da yokluğuna göre öncelikle iki gruba ayrıldı. Daha sonra gruplar, tekrar gebelik haftasına göre kendi içlerinde, 340/7-346/7 hafta olanlar(grup 1),350/7-356/7 hafta olanlar (grup 2), 360/7-366/7 hafta olanlar(grup 3) şeklinde üçe ayrıldı. Değerlendirme parametreleri: Gruplar prematürite ve erken membran rüptürü ile ilişkili yenidoğan komplikasyonları açısından karşılaştırıldı. Sonuç: Çalışmaya dahil edilen ikiyüz doksanbir olgunun 85'i PPROM nedeniyle erken doğum yapmıştı. 206'sı PPROM olmayan gruptaydı ve 76'sı 1. grup, 108'i 2. grup, 107'si de 3. grupta yer aldı. Sepsis oranı, birinci ve ikinci grupta üçüncü gruba göre daha yüksekti (p:0.016, p:0.029). Yenidoğan yoğunbakım ünitesinde (YDYB) kalış süresi 3. gruba oranla, 1. ve 2. grupta daha yüksekti (sırasıyla p:0.028, p:0.015). Birinci gruptaki yenidoğanlar, üçüncü gruptakilere göre anlamlı olarak daha uzun hastanede kalış süresine sahipti (p0.010), ve toplam hastanede kalış süresi sepsisli yenidoğanlarda anlamlı olarak daha yüksekti. Yorum: Özellikle daha erken gebelik haftalarında olan geç preterm yenidoğanlar, yenidoğan komplikasyonları için anlamlı olarak daha fazla risklidirler, aynı zamanda anlamlı olarak yenidoğan yoğun bakım ve hastanede daha uzun kalış süresine sahiptir.
Objective: Preterm deliveries increased in many countries in recent years. However, despite fetal lung maturity, substantial neonatal morbidity may occur even after 34 weeks of gestation. The aim of this study was to evaluate neonatal morbidity and mortality in women with late preterm births. Design: Retrospective. Setting: Duzce University School of Medicine, Departments of Obstetrics and Gynecology and Pediatrics. Patients: Medical records of 291 pregnant women and newborns born between the 340/7-366/7 weeks of gestation were reviewed. Interventions: The whole population is first divided into two groups as depending on the presence of PPROM or not; and then also divided into-three groups based on the gestational age at delivery as 340/7-346/7 week (Group 1), 350/7- 356/7 week (Group 2), and 360/7-366/7 week (Group 3). Main outcome measures: Groups were compared with respect to neonatal complications related to prematurity and early membrane rupture. Results: Of the 291 neonates included in the study, 85 were delivered preterm due to PPROM, 206 were non-PPROM group, and 76 were in group 1, 108 were in group 2, and 107 were in group 3. Sepsis rate was higher in group 1 and 2 compared to group 3 (p0.016, p0.029). NICU stay period was longer in group 1 and group 2 than group 3 (p0.028, p0.015 respectively). Newborns in group 1 had significantly longer hospital stay than group 3 (p0.010), and total hospital stay period were significantly higher in newborns with sepsis. Conclusions: The late-preterm infants especially in earlier weeks represent a significantly higher risk category for neonatal complications, and they have a significantly longer NICU and hospital stay period.
Objective: Preterm deliveries increased in many countries in recent years. However, despite fetal lung maturity, substantial neonatal morbidity may occur even after 34 weeks of gestation. The aim of this study was to evaluate neonatal morbidity and mortality in women with late preterm births. Design: Retrospective. Setting: Duzce University School of Medicine, Departments of Obstetrics and Gynecology and Pediatrics. Patients: Medical records of 291 pregnant women and newborns born between the 340/7-366/7 weeks of gestation were reviewed. Interventions: The whole population is first divided into two groups as depending on the presence of PPROM or not; and then also divided into-three groups based on the gestational age at delivery as 340/7-346/7 week (Group 1), 350/7- 356/7 week (Group 2), and 360/7-366/7 week (Group 3). Main outcome measures: Groups were compared with respect to neonatal complications related to prematurity and early membrane rupture. Results: Of the 291 neonates included in the study, 85 were delivered preterm due to PPROM, 206 were non-PPROM group, and 76 were in group 1, 108 were in group 2, and 107 were in group 3. Sepsis rate was higher in group 1 and 2 compared to group 3 (p0.016, p0.029). NICU stay period was longer in group 1 and group 2 than group 3 (p0.028, p0.015 respectively). Newborns in group 1 had significantly longer hospital stay than group 3 (p0.010), and total hospital stay period were significantly higher in newborns with sepsis. Conclusions: The late-preterm infants especially in earlier weeks represent a significantly higher risk category for neonatal complications, and they have a significantly longer NICU and hospital stay period.
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10
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3
