Neonatal morbidity in term neonates is related to gestational age at birth and level of care

Abstract

The objective of this study was to assess whether the incidence of neonatal morbidity of neonates born at term and admitted to a neonatal intensive care unit (NICU) differs by gestational age and level of care. This is a 5-year retrospective cohort study of singleton term births admitted to the NICU of the VU University Medical Center with a gestational age ≥37+0 weeks. In total, 497 neonates were included in the study. The incidence of neonates born with an arterial cord blood pH<7.10, neonatal asphyxia, and meconium aspiration syndrome increased with advancing gestational age. The incidence of secondary cesarean section and operative vaginal delivery also increased with advancing gestational age. Neonatal death occurred in 29 (5.84%) of the 497 cases; 27 (93%) of 29 were due to asphyxia. Seventeen (34%) of the 50 neonates born in primary care were admitted for asphyxia. Eight (47%) of these 17 neonates died. Neonatal morbidity in term neonates is related to gestational age at birth. Since asphyxia is an important cause of both morbidity and mortality in term neonates, it is important to clearly define and include asphyxia in future perinatal audits.