Maternal and infant morbidity following birth before 27 weeks of gestation: a single centre study - Sorbonne Université
Journal Articles Scientific Reports Year : 2021

Maternal and infant morbidity following birth before 27 weeks of gestation: a single centre study

Abstract

Delivery at extreme preterm gestational ages (GA) < 27 weeks is challenging with limited evidence often focused only on neonatal outcomes. We reviewed management and short term maternal, fetal and neonatal outcomes of births for 132 women (22 + 0 to 26 + 6 weeks' GA) with a live fetus at admission to hospital and in labour or at planned emergency Caesarean section: 103 singleton and 29 (53 live fetuses) twin gestations. Thirty women (23%) had pre-existing medical problems, 110 (83%) had antenatal complications; only 17 (13%) women experienced neither. Major maternal labour and delivery complications affected 35 women (27%). 151 fetuses (97%) were exposed to antenatal steroids, 24 (15%) to tocolysis and 70 (45%) to magnesium sulphate. Delivery complications affected 11 fetuses, with 12 labour or delivery room deaths; survival to discharge was 75% (117/156), increasing with GA: 25% (1/4), 75% (18/24), 69% (29/42), 73% (33/45) and 88% (36/41) at 22, 23, 24, 25 and 26 weeks GA respectively (p = 0.024). No statistically important impact was seen from twin status, maternal illness or obstetric management. Even in a specialist perinatal unit antenatal and postnatal maternal complications are common in extreme preterm births, emphasising the need to include maternal as well as neonatal outcomes.
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Dates and versions

hal-03342505 , version 1 (13-09-2021)

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Andrei S Morgan, Saadia Waheed, Shivani Gajree, Neil Marlow, Anna L David. Maternal and infant morbidity following birth before 27 weeks of gestation: a single centre study. Scientific Reports, 2021, 11 (1), pp.288. ⟨10.1038/s41598-020-79445-1⟩. ⟨hal-03342505⟩
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