Elective delivery at 34⁰(/)⁷ to 36⁶(/)⁷ weeks' gestation and its impact on neonatal outcomes in women with stable mild gestational hypertension

Am J Obstet Gynecol. 2011 Jan;204(1):44.e1-5. doi: 10.1016/j.ajog.2010.08.030.

Abstract

Objective: To examine the frequency of elective delivery and neonatal outcomes in women with stable mild gestational hypertension delivering late preterm.

Study design: The frequency of elective delivery between 1995 and 2007 at gestational age of 34⁰(/)⁷-36⁶(/)⁷ weeks (late preterm), 37⁰(/)⁷-37⁶(/)⁷ weeks, and ≥38⁰(/)⁷ weeks, as well as neonatal outcomes, were studied in singleton gestation with mild gestational hypertension without proteinuria from a large national database.

Results: One thousand eight hundred fifty-eight patients were studied: 607 (33%) were delivered for maternal/fetal reasons and 1251 (67%) were electively delivered. Among the 1251 women delivered electively, 25.5% were late preterm, 24.4% at 37⁰(/)⁷-37⁶(/)⁷ weeks and 50.1% at ≥38⁰(/)⁷ weeks' gestation. Neonatal intensive care unit admission, ventilatory assistance, and respiratory distress syndrome were more common in late-preterm infants. There was no maternal/perinatal mortality.

Conclusion: We found that 25.5% of patients with stable mild gestational hypertension, without any maternal or fetal complication, had iatrogenic elective late-preterm delivery. This practice also was associated with increased rates of neonatal complications and neonatal length of stay.

MeSH terms

  • Adolescent
  • Adult
  • Delivery, Obstetric / adverse effects
  • Delivery, Obstetric / methods*
  • Female
  • Gestational Age
  • Humans
  • Hypertension, Pregnancy-Induced*
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Middle Aged
  • Pregnancy
  • Premature Birth*
  • Respiration, Artificial / statistics & numerical data
  • Respiratory Distress Syndrome, Newborn / etiology
  • Retrospective Studies
  • Young Adult