Original scientific paper

Small for gestational age in mild and moderate preterm delivery at Split University Hospital Centre: effect of delivery mode on neonatal outcome a three year retrospective study

Luka Vulić orcid.org/0000-0001-5877-519X ; Health Centre Split, Split, Croati
Marko Vulić orcid.org/0000-0002-3198-4976 ; Split University Hospital Centre, Department of gynecologic and obstetrics; University of Split, School of medicine

Abstract

In the present study, we aim to assess whether there is a difference in cesarean delivery incidence in moderate and mild preterm birth. This retrospective study included singleton pregnancies with moderate and mild preterm birth in the period from January 1, 2015 to December 31, 2017. The following variables were investigated: maternal age (years), parity, week of pregnancy (≤32-33+6/7 and 34-36+6/7 ), and mode of delivery (vaginal and cesarean section), birth weight (grams) and 5 min Apgar score (≤7, 8-10). Five hundred and eighty six women had preterm delivery in that period and 521 met inclusion criteria. Sixty-nine were born from 32-33+6/7 and 452 from 34-36+6/7 weeks of pregnancy. There was not a statistically significant difference in the age and parity between groups (p=0.6406). There was a statistically significant difference in delivery mode (χ2=21.5634; p<0.001), the rate of small for gestational age (SGA) neonates (χ2=22.6002; p<0.001) and Apgar score (χ2=77.8317; p<0.01) between the study groups.
Statistical analysis revealed the difference in APGAR score according to delivery mode between moderate and mild SGA newborns (χ2=16.2398; p<0.0001). We found a difference in incidence of cesarean delivery according to the relation of newborn weight with gestational age between the investigated groups. (χ2=43.8247; p<0.0001).
We found a correlation of APGAR score and mode of delivery in mild (χ2=24.3262; p<0.0004) but not in moderate (χ2=5.8245; p<0.4413) newborns.
There was a statistical difference in APGAR score according to mode of delivery in mild and moderate SGA newborns (χ2=16.2398; p<0.001).
In conclusion, we found that the delivery mode has no impact on perinatal outcome according to APGAR score in the 5th minute. There is increased incidence of SGA and cesarean delivery in moderate preterm group. There is a difference in APGAR score in 5th minute between mild and moderate preterm infants. In subgroup of SGA newborns, delivery mode has an impact on APGAR score in the 5th minute. Increased incidence of SGA babies in moderate preterm birth group could be an indicator of hostile intrauterine environment and preterm birth could be seen as a protective mechanism.

Keywords

perinatal outcome; preterm birth; SGA

Hrčak ID:

236686

URI

https://hrcak.srce.hr/236686

Publication date:

9.4.2020.

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