Evaluation of respiratory problems according to week of delivery: A comparative analysis in infants of gestational age 37 weeks

Abstract

Background: Cesarean section deliveries at 37 weeks gestational period are incredibly high in Turkey. In order to determine the antenatal characteristics, respiratory morbidity and mortality cases, we have conducted a retrospective cohort study on this population. Methods: 514 infants encountering clinical signs of respiratory distress within 24 hours were enrolled. To compare the differences, infants were categorized into three groups as: late-preterm, early-term and full-term infants. Demographic and clinical data were explored. Results: Early-term infants represented higher RDS rates (13.1%; P = 0.033 for early-term and full-term infants; P = 0.338 for early-term and late-preterm infants), meconium aspiration syndrome (P < 0.001 for early-term and late-preterm infants; P < 0.001 for early-term and full-term infants) and lower Apgar scores at 5 minutes (6.1 ± 1.98; P < 0.001 for early-term and full-term infants; P = 0.642 for early-term and late-preterm infants). They necessitated conventional mechanical ventilation more often compared to late-preterm and full-term neonates (39.3%; P = 0.050, P = 0.042); however late-preterm infants represented longer intubation periods (P = 0.014, P < 0.001) and intensive care stays (P < 0.001; P < 0.001). Conclusions: Early-term neonates encounter respiratory problems, morbidities and significant respiratory distress syndrome rates similar to the rates of late preterm neonates and seemed to have a tendency to hypoxic deliveries with low Apgar scores. Considering the increasing delivery rate at this period, real estimates should be investigated in large, multi-centered prospective studies in terms of both short and long term outcomes.