January 19, 2016

Post-Term Delivery Raises Risk of Complications, Illness for Newborns

TEL AVIV, Israel -- January 19, 2016 -- Post-term deliveries, even among low-risk pregnancies, are associated with increased short-term risks to newborns, including illnesses and infections, which land them twice as frequently in the neonatal intensive care units (NICUs).

The study, published in the Archives of Disease in Childhood, Fetal and Neonatal Edition, isolates the post-term due date as a single, influential risk factor for the first time.

“There are women who refuse induction of labour, even more than 2 weeks past their due date,” said Liran Hiersch, MD, Tel Aviv University, Tel Aviv, Israel. “Without the relevant data, it is difficult for doctors to convince them otherwise. Maybe now, with this research and further studies in hand, we can convince them that even though their pregnancies had experienced no complications -- and they are being monitored, say, every 3 days -- they’re potentially risking infection, illness and other unforeseen complications by refusing medical intervention.”

The researchers examined the electronic records of all women who delivered babies at Rabin Medical Center, Petah Tikva, Israel, over a 5-year period. They extracted the records of approximately 23,500 women with a single fetus and without pregnancy complications who delivered at 39 to 44 weeks of gestation. Then they compared the neonatal outcomes of 3 groups: neonates born at 39 to 40 weeks; neonates born at 41 weeks; and neonates born at 42 weeks and later (post-date pregnancies).

“Although previous studies demonstrated an increased risk of complications for newborns born in the post-term period, most of these studies included women with pregnancy-related complications, such as small fetuses, hypertension, and diabetes mellitus,” said Dr. Hiersch. “The isolated effect of the prolonged pregnancy could not be determined. For this reason, we included in our analysis only women with low-risk pregnancies in order to more clearly determine the effect of gestational age at delivery on neonatal outcome.”

The researchers only addressed women who gave birth to live infants, excluding all cases of still-borns, in order to effectively isolate the influence of time of delivery on the infant.

Results showed that infants born past 42 weeks had approximately twice the risk of contracting infections, experiencing respiratory difficulties and being admitted to NICUs than those born at 39 to 40 weeks.

“Our study implies that even in otherwise low-risk pregnancy, it is advisable not to postpone delivery beyond 42 weeks,” said Dr. Hiersch. “Therefore, it is reasonable to offer induction of labour to women reaching that time of pregnancy and maybe a little earlier.”

SOURCE: American Friends of Tel Aviv University

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