Evaluation of Neonatal Health in Prolonged Pregnancy in Shabih-Khani Hospital, Kashan, ۲۰۰۳

Background and Objective: Prolonged pregnancy influences different aspects of maternal and neonatal health. Although it is generally accepted that drug intervention is necessary before labor in prolonged pregnancy, there is still debate about the termination time of the pregnancy. Regarding the high prevalence of prolonged pregnancy we studied the neonatal health in the  hospitalized women with prolonged pregnancy in kashan, in ۲۰۰۲-۲۰۰۳. Materials and Methods: This descriptive study was carried out on ۴۵۰ women at gestational age over ۴۰ weeks (based on their LMP or sonography before ۳۰ weeks) admitted for termination of pregnancy by induction. The cases had no obstetrical problems. Neonatal health including type of delivery and dystocia, fetal distress, meconium, apgar in ۵ minutes, NICU (neonatal intensive care unit) stay and weight were recorded and the cases were categorized into ۴ groups based on gestational age: ۴۰ weeks to ۴۰weeks and ۳days, ۴۰weeks and ۴days to ۴۱weeks, ۴۱weeks and ۱days to ۴۱weeks and ۳days and ۴۱weeks and ۴days and more. The results were analyzed by descriptive statistics chi-square, Kruskal-Wallis, and Mann-Whitney. Results: The results showed that studied women terminated their pregnancy as follows: ۱۳۱ individuals (۲۹/۱%) terminated their pregnancy during ۴۰ to ۴۰weeks and ۳ days, ۱۵۰(۳۳.۳%) during ۴۱ weeks and ۱ day to ۴۱ weeks and ۳ days, and only ۳۹ women (۸/۷%) terminated their pregnancy after ۴۱weeks and ۳days, ۱۲ (۲/۷%) of whom were over ۴۲ weeks. There was no significant difference between women in fetal stress, meconium, apgar in ۵ minutes, NICU stay, neonatal weight, type of delivery and dystocia. However, the studied groups differed singnificantly in terms of cesarean cause based on pregnancy. Statistical tests showed that the studied groups in terms of motherchr('۳۹')s age (P=۰.۴), the history of prolonged pregnancy (p=۰.۰۸), number of parities (p=۰.۷), dilatation (p=۰.۲), cervix effacement based on pregnancy age had no significant difference. Conclusion: Based on the study results, termination of pregnancy prior to ۴۱.۵ weeks of gestational age due  to fear of neonatal outcome is not necessary. Pre- term intervention  can cause enhancement of cesarean. Thus, pregnancy termination could be delayed in pregnant women who are under control and have no compilcations.

Keywords:

Prolonged pregnancy , Neonatal outcome , High risk neonate