Neonatal outcomes in early term neonates versus term neonates in a tertiary care hospital - A cross sectional comparative study

Background: Preterm birth is one of the chief causes of neonatal mortality and morbidity. The larger studies presented higher rate of adverse outcomes in association to term infants in contrast of neonatal mortality and morbidity. The majority of studies confirmed significantly higher rate of adverse outcomes in preterm in the contrast of neonatal mortality and morbidity. In this contest, we studied the association between different antenatal parameters between early term neonates and full term neonates and to compare neonatal complications. Materials and methods: A total 180 neonates born in the study setting, for a period of 6 months were included and study was conducted in Department of Neonatology and Obstetrics and Gynecology in a tertiary care teaching hospital in south India. A structured and validated case report form was designed for the purpose of data collection. The tool was validated by including the inputs from five experts in the subject area. Descriptive analysis of demographic parameters, antenatal and intra natal parameters were done. Chi square test was used to assess the statistical significance of the association. P value < 0.05 was considered as statistically significant. IBM SPSS version 21 was used for statistical analysis. Results: A total of 180 infants were included in the study, out of which 92 infants (51.1%) were early term and the remaining 88 (48.9%) were full term infants. The odds of early term pregnancy were 2.44 (95 % CI 1.04 to 5.7, p value 0.028) times higher in diabetic mothers, compared to mothers without diabetes. The odds of early term pregnancy was 4.08(95% CI 1.66 to 10.06, p value 0.001) for maternal hypertension and 11.81(95% CI 1.50 to 93.77, p value 0.004) for maternal anemia. The proportion of LSCS was quite high in early term pregnancy, compared to term pregnancy (52.2% Vs 18.2%, p value <0.001). The proportion of small for gestational age (SGA) babies was 29.7% in early term pregnancies (P value 0.011). The odds of hypoglycemia were 3.42 times more in ET pregnancies, compared to full term pregnancies (OR 3.423, 95 % CI 1.37 to 8.52, p value 0.006). Conclusion: The early-term delivery is associated with greater morbidity. There was reasonable relationship was evident involving maternal diabetes mellitus, hypertension, anemia, IUGR and early term pregnancy. The proportion of LSCS was reasonably high in early term pregnancy with slightly higher proportion small for gestational age babies. Neonatal intensive care admissions were found higher in early term than full term pregnancies. Further, there is continual relationship between gestational age and neonatal morbidity from early pregnancy.