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Perinatal morbidity and mortality in late-term and post-term pregnancy. NEOSANO perinatal network's experience in Mexico

Journal of Perinatology volume 31, pages 789–793 (2011)Cite this article

Subjects

Abstract

Objective:

The objective of this study is to identify adverse perinatal outcomes associated with pregnancies at or beyond 40 weeks.

Study Design:

Retrospective cohort study conducted in Mexico, with information obtained from the NEOSANO's Perinatal Network Database from April 2006 to April 2009. Multiple births, babies with inaccurate gestational age or babies with congenital malformations were excluded. Logistic regression models were used to analyze perinatal complications associated with pregnancies ⩾40 weeks.

Result:

A total of 21 275 babies were analyzed; of these, 4545 (21.3%) were of 40 to 40[fraction 6 over 7] weeks, 3024 (14.2%) 41 to 41[fraction 6 over 7] weeks and 388 (1.8%) 42 to 44 weeks of gestation. Adverse perinatal outcomes associated with 40 to 40[fraction 6 over 7] weeks deliveries were (odds ratio; 95% confidence interval): macrosomia (1.9; 1.5 to 2.6), acute fetal distress (1.4; 1.2 to 1.7), emergency cesarean delivery (1.4; 1.2 to 1.5) and chorioamnionitis (1.4; 1.2 to 1.6). Adverse perinatal outcomes associated with 41 to 41[fraction 6 over 7] weeks were macrosomia (2.5; 1.8 to 3.3), chorioamnionitis (2; 1.7 to 2.3), emergency cesarean delivery (1.8; 1.6 to 2.1) and acute fetal distress (1.4; 1.1 to 1.7). Adverse perinatal outcomes associated with 42 to 44 weeks were macrosomia (7; 4.6 to 10.7), meconium aspiration syndrome (5.6; 2.8 to 11.2), neonatal death (4.8; 1.7 to 13.8), stillbirth (4.3; 1.4 to 13.5), 5′ Apgar <4 (4.2; 1.1 to 15.7), chorioamnionitis (2.8; 2.2 to 3.9), admission to neonatal intensive care unit (2.7; 1.5 to 4.8), admission to neonatal intensive care unit or step-down unit (2.4; 1.5 to 3.9), acute fetal distress (1.8; 1.2 to 2.6) and emergency cesarean delivery (1.8; 1.3 to 2.4).

Conclusion:

An increased risk for perinatal and maternal complications were detected as early as 40 weeks’ gestation. The risks of stillbirth and neonatal death were significantly higher in the post-term group than the control group.

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Acknowledgements

The authors are grateful to Alfonso Reyes for his assistance in data analyses, John Kasik for his critical review of the manuscript and Ana Carla Argüelles Albarrán for secretarial assistance.

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Authors and Affiliations

  1. Department of Neonatology, Hospital Infantil de Mexico Federico Gomez, México City, México

    A M De los Santos-Garate, M Villa-Guillen, D Villanueva-García & M L Vallejos-Ruíz

  2. National Center for Child and Adolescent Health (CeNSIA), México City, México

    M T Murguía-Peniche

Authors
  1. A M De los Santos-Garate
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  2. M Villa-Guillen
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  3. D Villanueva-García
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  4. M L Vallejos-Ruíz
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  5. M T Murguía-Peniche
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Consortia

the NEOSANO's Network

Corresponding author

Correspondence to M T Murguía-Peniche.

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The authors declare no conflict of interest.

Appendix

Appendix

Participants of NEOSANO's Perinatal Network:

Dr Lino Cardiel and Dr Edgar Reynoso; Hospital General de México, Mexico City. Dr Ana Limón Rojas; Hospital Pemex Sur, Mexico City. Dr Alberto Orozco and Dr Sergio Graham; Hospital Angeles Pedregal, Mexico City.

Dr Jose Iglesias and Dr Isabel Bernárdez; Hospital Español, Mexico City. Dr Jose Hernandez; Hospital Medica Sur, Mexico City. Dr Jesus Salcedo Hospital Valdivieso, Oaxaca City, Oaxaca. Dr Livia Flores, Dr Roberto Tepatzi; Hospital General, Hospital Santa Ana, Hospital Apizaco, Tlaxcala City, Tlaxcala.

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De los Santos-Garate, A., Villa-Guillen, M., Villanueva-García, D. et al. Perinatal morbidity and mortality in late-term and post-term pregnancy. NEOSANO perinatal network's experience in Mexico. J Perinatol 31, 789–793 (2011). https://doi.org/10.1038/jp.2011.43

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