Article Text

SHORT-TERM MORBIDITY IN POST-TERM INFANTS
  1. E Skogvoll3,
  2. B Theting2,
  3. O J Johansen2,
  4. R Heimstad4
  1. 1Department of Anaesthesia, St. Olav University Hospital, Trondheim, Norway,
  2. 2Department of Paediatrics, St. Olav University Hospital, Trondheim, Norway,
  3. 3Unit for Applied Clinical Research, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway,
  4. 4Department of Obstetrics, St. Olav University Hospital, Trondheim, Norway

Abstract

Objective Post-term babies have increased risk of complications, such as asphyxia and meconium aspiration syndrome. The aim of this study was to describe contemporary Norwegian short-term neonatal morbidity beyond 41 weeks of gestation.

Methods Data were obtained in a randomised clinical trial comparing induction of labour with expectant management at 41 weeks of pregnancy, showing no difference in outcome. (.1) A total of 508 post-term neonates born from 2002 to 2004 were examined by a paediatrician according to a prospective protocol.

Results Median gestational age was 291 days (range 287 to 302), median birth weight was 3970 g (range 2790 to 5150), median Apgar score at 5 minutes was 10 (range 3 to 10), median pH was 7.27 (range 6.86 to 7.52), and median base excess was −3 (range −18 to 7).

Twenty neonates (4%) were resuscitated at birth, mainly needing ventilation. One patient died. Meconium stained amniotic fluid was seen in 156 (31%), but meconium aspiration syndrome was diagnosed in only 4 neonates (1%). A total of 32 neonates (7%) were admitted to intensive care for a median stay of 6 days (range 1–15). Overall neonatal morbidity (1) correlated with increasing gestational age (Spearman’s rho = 0.10, p = 0.02).

Conclusions With proper antenatal care, expedient resuscitation, and access to neonatal intensive care, contemporary short-term morbidity in post-term infants is very low. In particular, meconium aspiration syndrome was rare despite a notable prevalence of meconium staining.

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