Is 34 weeks of gestation an acceptable goal for a complicated singleton pregnancy?

Abstract

Objective: To assess the incidence of NICU admission, respiratory distress syndrome (RDS), and ventilator use in infants delivering between 34 and 36 weeks of gestation because of preterm labor (PTL). Study design: Singleton gestations with delivery at 34–36 weeks of gestation because of PTL were identified from a database of women completing an outpatient PTL identification program between May 1995 and March 2000. Inclusion criteria were PTL hospitalization leading to delivery without attempted tocolysis. Excluded were indicated deliveries. Statistics used included ANOVA, Kruskal-Wallis H and Pearson’s X 2. Results: A total of 2,849 infants were identified. Risk of NICU admission decreases by 47.4% from weeks 34 to 35 and by 41.9% from weeks 35 to 36 (all P values below are <0.004). Data are presented as mean ± SD, or percentage as indicated. 34 weeks n = 370 35 weeks n = 783 36 weeks n = 1,696 NICU 54.6% 28.7% 16.7% NICU days 9.5 ± 10.9 8.1 ± 9.1 7.7 ± 8.1 RDS 12.2% 9.1% 5.4% Ventilator use 9.2% 5.6% 3.1% Conclusion: Rates of NICU admission, RDS, and need for ventilatory assistance decrease significantly with each advancing week of gestation. These data indicate that benefit is derived in prolonging pregnancy beyond 34 weeks.