468 Long-Term respiratory outcomes in early term born offspring: a systematic review and Meta-Analysis

Abstract

Newborns exhibit the lowest immediate respiratory morbidity rates when born following 39 completed weeks of gestation. We sought to systematically review the literature and evaluate whether early-term deliveries (370/7-386/7 weeks of gestation) have an impact on long-term respiratory outcomes of offspring up to the age of 18 years, as compared to offspring born at full term or later. This systematic review and meta-analysis was conducted according to the PRISMA guidelines and was registered in PROSPERO. We searched Medline, Embase, and relevant reference lists up to May 31st , 2020, including any observational or randomized trials addressing the association. Two independent reviewers extracted data, and assessed risk of bias. Pooled relative risk (RRs) with their 95% confidence intervals (95% CIs) and heterogeneity were determined. Publication bias was assessed by Funnel plots with Eggers regression line and contours, and sensitivity analyses were performed using Baujat plots. Fifteen studies were included following a screen of nearly 2000 abstracts. Early term birth significantly increased the risk of total respiratory morbidity in the offspring (RR= 1.17, 95%CI= 1.13, 1.22) as compared to full term birth (Figure 1). The increased respiratory morbidity was attributed to obstructive airway diseases (RR=1.14, 95%CI= 1.09, 1.19, Figure 2a) and infectious respiratory diseases (RR= 1.20, 95%CI= 1.11, 1.30, Figure 2b). Compared with full term born offspring, early term delivery poses a significant risk for long term pediatric respiratory morbidity.View Large Image Figure ViewerDownload Hi-res image Download (PPT)