The effects of maternal risk factors on the morbidity of late preterm infants in the neonatal intensive care unit

Premature infants are defined that baby is born before completing the 37th gestational week. It is a heterogeneous group, infants are born within the viability border of 220/6 weeks to 366/7 weeks. Late preterm infants who are born between 34 0/7 and 36 6 / 7 gestational weeks occur in 70% of all live births before 37 completed weeks. Late preterms are often considered to be mature, functional and developmental and therefore treated as full-term babies, which can result in overlooked problems. In this study; 242 infants born between 01/01/2012-30/06/2015 in our Obstetrics and Gynecology Department, Perinatology Division were evaluated. The infants included were between 34 0 / 7- 36 6/7 gestational weeks according to the mother's last menstrual period and ultrasound signs, and were born by normal vaginal or cesarean section. Neonatal morbidity and mortality occurring in these infants due to maternal risk factors were evaluated. There were 74,89 and 79 infants born in 34,35 and 36th gestational weeks respectively . Exclusion criteria included multiple congenital malformations, chromosomal disorders and patients admitted from elsewhere to our clinic. The most common morbidities in our study were feeding intolerance (70.2%), hyperbilirubinemia (43.0%), neonatal transient tachypnea (40.0%), hypoglycemia (16.9%), respiratory distress syndrome (15.7%) and sepsis (13.7%) . The most common treatments performed during intensive care were intravenous fluid infusions (88.4%), hood inner oxygen support (54.5%) and antibiotic treatment (31.8%). Respiratory distress syndrome (RDS) was seen more with mothers having ablation plasenta, transient tachypnea of the newborn correlated positively with oligohydramiosis. Polycythemia was seen with maternal gestational diabetes mellitus and hypoglycemia with placenta previa. Between the gestational age groups (34, 35. and 36 weeks); length of neonatal intensive care hospitalization , mortality, respiratory distress, feeding intolerance, and the number of treatments received were higher in 34th gestational week group. The objectives of this study were; 1) To determine the maternal antenatal risk for the late premature infants hospitalized in neonatal intensive care unit and respiratory, metabolic, infectious, hematologic, neurologic and gastrointestinal system morbidities in these patients. 2) To determine the maternal risk factors effecting the morbidity of these infants. 3) To give information to obstetrics and gynecology department and pediatrics/neonatal services about the possible complications that can occur in these patients, and to be used as a guide for the timing of the birth. Also, to regulate the family education given before discharge and the frequency of monitoring according to the results of this study; and detecting the late preterm infant problems early as a result. In conclusion, we find that babies born in 34.gestasyonal week had more morbidities compared with other weeks. Preeclampsia, placenta previa and placental problems such as placental abruption, oligohydramnios and gestational diabetes mellitus were all associated with increased morbidity. Therefore, screening the infants with these maternal risk factors will affect the early treatment and follow up plan, increasing the efficiency of neonatal care.