Optimal time of delivery to reduce the risk of infant mortality in small and normally grown fetuses: A national cohort study in Korea
PURPOSE: To examine the competing risks of stillbirth versus infant death and to evaluate the optimal time of delivery in the population of small for gestational age (SGA) and non-SGA late preterm and term fetuses. METHODS: This was a retrospective national cohort study of all singleton births betwe...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294352/ https://www.ncbi.nlm.nih.gov/pubmed/30550584 http://dx.doi.org/10.1371/journal.pone.0209308 |
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author | Ko, Hyun Sun Wie, Jeong Ha Choi, Sae Kyung Park, In Yang Park, Yong-Gyu Shin, Jong Chul |
author_facet | Ko, Hyun Sun Wie, Jeong Ha Choi, Sae Kyung Park, In Yang Park, Yong-Gyu Shin, Jong Chul |
author_sort | Ko, Hyun Sun |
collection | PubMed |
description | PURPOSE: To examine the competing risks of stillbirth versus infant death and to evaluate the optimal time of delivery in the population of small for gestational age (SGA) and non-SGA late preterm and term fetuses. METHODS: This was a retrospective national cohort study of all singleton births between 34 0/7 and 42 6/7 weeks of gestation using the Korean vital statistics (n = 2,106,159). We compared the risk of infant mortality with a composite of fetal–infant mortality risk that would occur after expectant management for one additional week and evaluated the optimal time of delivery, in SGA and non-SGA pregnancies. RESULTS: In the total population, the risk of expectant management became significantly higher than the risk of delivery, at 39 weeks and beyond, similar with non-SGA group. In the SGA group, the risk of stillbirth was significantly greater at all GAs than for non-SGA pregnancies, and the risk of infant death was significantly increased until 38 weeks (25.8 per 10,000 live births, 95% CI 20.11–32.47), and the risk of stillbirth was significantly increased at 41 weeks (11.65 per 10,000 ongoing pregnancies, 95% CI 6.95–18.09), compared to 39 weeks (12 per 10,000 live births, 95% CI 8.98–15.64 and 5.12 per 10,000 ongoing pregnancies, 95% CI 3.84–6.66, respectively). CONCLUSION: In Korean women, delivery between 39 and 41 weeks minimizes fetal/infant mortality, in non-SGA pregnancies. In uncomplicated SGA pregnancies, delivery between 39 and 40 weeks can be considered to decrease risk of infant death and stillbirths. |
format | Online Article Text |
id | pubmed-6294352 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-62943522018-12-28 Optimal time of delivery to reduce the risk of infant mortality in small and normally grown fetuses: A national cohort study in Korea Ko, Hyun Sun Wie, Jeong Ha Choi, Sae Kyung Park, In Yang Park, Yong-Gyu Shin, Jong Chul PLoS One Research Article PURPOSE: To examine the competing risks of stillbirth versus infant death and to evaluate the optimal time of delivery in the population of small for gestational age (SGA) and non-SGA late preterm and term fetuses. METHODS: This was a retrospective national cohort study of all singleton births between 34 0/7 and 42 6/7 weeks of gestation using the Korean vital statistics (n = 2,106,159). We compared the risk of infant mortality with a composite of fetal–infant mortality risk that would occur after expectant management for one additional week and evaluated the optimal time of delivery, in SGA and non-SGA pregnancies. RESULTS: In the total population, the risk of expectant management became significantly higher than the risk of delivery, at 39 weeks and beyond, similar with non-SGA group. In the SGA group, the risk of stillbirth was significantly greater at all GAs than for non-SGA pregnancies, and the risk of infant death was significantly increased until 38 weeks (25.8 per 10,000 live births, 95% CI 20.11–32.47), and the risk of stillbirth was significantly increased at 41 weeks (11.65 per 10,000 ongoing pregnancies, 95% CI 6.95–18.09), compared to 39 weeks (12 per 10,000 live births, 95% CI 8.98–15.64 and 5.12 per 10,000 ongoing pregnancies, 95% CI 3.84–6.66, respectively). CONCLUSION: In Korean women, delivery between 39 and 41 weeks minimizes fetal/infant mortality, in non-SGA pregnancies. In uncomplicated SGA pregnancies, delivery between 39 and 40 weeks can be considered to decrease risk of infant death and stillbirths. Public Library of Science 2018-12-14 /pmc/articles/PMC6294352/ /pubmed/30550584 http://dx.doi.org/10.1371/journal.pone.0209308 Text en © 2018 Ko et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Ko, Hyun Sun Wie, Jeong Ha Choi, Sae Kyung Park, In Yang Park, Yong-Gyu Shin, Jong Chul Optimal time of delivery to reduce the risk of infant mortality in small and normally grown fetuses: A national cohort study in Korea |
title | Optimal time of delivery to reduce the risk of infant mortality in small and normally grown fetuses: A national cohort study in Korea |
title_full | Optimal time of delivery to reduce the risk of infant mortality in small and normally grown fetuses: A national cohort study in Korea |
title_fullStr | Optimal time of delivery to reduce the risk of infant mortality in small and normally grown fetuses: A national cohort study in Korea |
title_full_unstemmed | Optimal time of delivery to reduce the risk of infant mortality in small and normally grown fetuses: A national cohort study in Korea |
title_short | Optimal time of delivery to reduce the risk of infant mortality in small and normally grown fetuses: A national cohort study in Korea |
title_sort | optimal time of delivery to reduce the risk of infant mortality in small and normally grown fetuses: a national cohort study in korea |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294352/ https://www.ncbi.nlm.nih.gov/pubmed/30550584 http://dx.doi.org/10.1371/journal.pone.0209308 |
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