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Elective delivery at 340/7 to 366/7 weeks' gestation and its impact on neonatal outcomes in women with stable mild gestational hypertension

2010; Elsevier BV; Volume: 204; Issue: 1 Linguagem: Inglês

10.1016/j.ajog.2010.08.030

1097-6868

John R. Barton, Lucy Barton, Niki Istwan, Cheryl Desch, Debbie Rhea, Gary Stanziano, Baha M. Sibai,

Maternal Mental Health During Pregnancy and Postpartum

To examine the frequency of elective delivery and neonatal outcomes in women with stable mild gestational hypertension delivering late preterm.The frequency of elective delivery between 1995 and 2007 at gestational age of 34⁰(/)⁷-36⁶(/)⁷ weeks (late preterm), 37⁰(/)⁷-37⁶(/)⁷ weeks, and ≥38⁰(/)⁷ weeks, as well as neonatal outcomes, were studied in singleton gestation with mild gestational hypertension without proteinuria from a large national database.One thousand eight hundred fifty-eight patients were studied: 607 (33%) were delivered for maternal/fetal reasons and 1251 (67%) were electively delivered. Among the 1251 women delivered electively, 25.5% were late preterm, 24.4% at 37⁰(/)⁷-37⁶(/)⁷ weeks and 50.1% at ≥38⁰(/)⁷ weeks' gestation. Neonatal intensive care unit admission, ventilatory assistance, and respiratory distress syndrome were more common in late-preterm infants. There was no maternal/perinatal mortality.We found that 25.5% of patients with stable mild gestational hypertension, without any maternal or fetal complication, had iatrogenic elective late-preterm delivery. This practice also was associated with increased rates of neonatal complications and neonatal length of stay.