Neonatal morbidity after documented fetal lung maturity in late preterm and early term infants.

Division of Neonatology and Pulmonary Biology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, OH 45229, USA.
American journal of obstetrics and gynecology (Impact Factor: 3.97). 06/2011; 204(6):518.e1-8. DOI: 10.1016/j.ajog.2011.03.038
Source: PubMed

ABSTRACT Fetal lung maturity often is used as the sole criterion that late preterm infants are ready for postnatal life. We therefore tested the hypothesis that fetal lung maturity testing does not predict the absence of morbidity in late preterm infants.
We performed a retrospective cohort study to examine 152 infants who were born in the late preterm (34 0/7 to 36 6/7 weeks) and early term (37 0/7 to 38 6/7 weeks) periods after mature fetal lung indices and compared them with 262 infants who were born at ≥39 weeks' gestation and who were matched by mode of delivery.
Despite documented fetal lung maturity, infants who were born at <39 weeks had significantly higher rates of neonatal morbidities compared with infants who were born at ≥39 weeks' gestation. After adjustment for significant covariates, we found that infants who were born at <39 weeks' gestation had an increased risk of composite adverse outcome (odds ratio, 3.66; 95% confidence interval, 1.48-9.09; P < .01).
Fetal lung maturity testing is insufficient to determine an infant's readiness for postnatal life.

  • [Show abstract] [Hide abstract]
    ABSTRACT: AMNIOCENTESIS FOR FETAL LUNG MATURITY HAS HISTORICALLY BEEN PERFORMED FOR MANY REASONS: uterine and placental complications, maternal comorbidities, fetal issues, and even obstetric problems. Even though the risks associated with third trimester amniocentesis are extremely low, complications have been documented, including preterm labor, placental abruptions, intrauterine rupture, maternal sepsis, fetal heart rate abnormalities, and fetal-maternal hemorrhage. This review presents the types of tests for fetal lung maturity, presents the indications and tests utilized, and discusses recommendations for when amniocentesis for fetal lung maturity may be appropriate.
    Reviews in obstetrics and gynecology 01/2013; 6(3-4):126-34.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Respiratory distress syndrome is a major cause of neonatal morbidity and mortality that is most commonly caused by a deficiency in lung surfactant in premature infants. Therefore, laboratory tests were developed to measure the presence and/or concentration of lung surfactant in amniotic fluid in order to estimate maturity of the fetal lung. Although these tests were once widely employed, their utilization by physicians has decreased in recent years. Several studies have shown that demonstration of a mature fetal lung index by antenatal testing does not improve neonatal outcomes. Instead, decreased respiratory and nonrespiratory morbidities are most highly correlated with gestational age of the fetus. Therefore, fetal lung maturity testing may have passed the point of being clinically useful.
    Biomarkers in Medicine 04/2014; 8(4):509-15. · 3.22 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Late preterm infants (34-36weeks gestation) have a morbidity rate significantly higher than those born at term. However, few interventions have been undertaken to reduce this increased morbidity and mortality. Antenatal corticosteroid administration could be an effective preventive measure. The aim of this study was to describe the morbidity associated with late prematurity in our institution, and determine if there are differences between those who received antenatal corticosteroids. A prospective observational study was conducted on late preterm infants born in a tertiary hospital from October 2011 until September 2012. Two groups were formed according to whether or not they had received antenatal steroids. The rates of morbidity and mortality for each of the groups were analysed and compared. There was a total of 4127 live newborns during the study period, of whom 3795 were term and 332 were preterm (the overall prematurity rate was 8.04%). There were 247 late preterm deliveries, representing 6% of live born infants, and 74.4% of all premature infants. Of late preterm infants, 63.2% were admitted to the Neonatal Unit and 29.6% had received antenatal steroids. The incidence of admission to the Neonatal Unit and Neonatal Intensive Care, transient tachypnea, need for respiratory support in the form of continuous positive pressure airway and oxygen therapy, incidence of hypoglycemia, feeding difficulty, and jaundice requiring phototherapy were significantly higher (P<.05) in the late preterm group that did not receive antenatal steroids. Our finding suggests that the administration of antenatal corticosteroids to patients at risk of 34-36weeks delivery could significantly reduce the cost and acute morbidity associated with late preterm birth.
    Anales de Pediatría 03/2014; · 0.87 Impact Factor


Available from
Jun 4, 2014