Effects of ultrasound pregnancy dating on neonatal morbidity in late preterm and early term male infants: a register-based cohort studyReportar como inadecuado




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BMC Pregnancy and Childbirth

, 16:335

Maternal health and pregnancy

Abstract

BackgroundAssessing gestational age by ultrasound can introduce a systematic bias due to sex differences in early growth.

MethodsThis cohort study included data on 1,314,602 births recorded in the Swedish Medical Birth Register. We compared rates of prematurity-related adverse outcomes in male infants born early term gestational week 37–38 or late preterm gestational week 35–36, in relation to female infants, between a time period when pregnancy dating was based on the last menstrual period 1973–1978, and a time period when ultrasound was used for pregnancy dating 1995–2010, in order to assess the method’s influence on outcome by fetal sex.

ResultsAs expected, adverse outcomes were lower in the later time period, but the reduction in prematurity-related morbidity was less marked for male than for female infants. After changing the pregnancy dating method, male infants born early term had, in relation to female infants, higher odds for pneumothorax Cohort ratio CR 2.05; 95 % confidence interval CI 1.33–3.16, respiratory distress syndrome of the newborn CR 1.99; 95 % CI 1.33–2.98, low Apgar score CR 1.26; 5 % CI 1.08–1.47, and hyperbilirubinemia CR 1.12; 95 % CI 1.06–1.19, when outcome was compared between the two time periods. A similar trend was seen for late preterm male infants.

ConclusionMisclassification of gestational age by ultrasound, due to size differences, can partially explain currently reported sex differences in early term and late preterm infants’ adverse neonatal outcomes, and should be taken into account in clinical decisions and when interpreting study results related to fetal sex.

KeywordsPregnancy dating Ultrasound Gestational age Antenatal Infant Morbidity AbbreviationsBPDBiparietal diameter

CIConfidence interval

CRCohort ratio

EDDEstimated delivery date

GAGestational age

ICDInternational classification of diseases

IVFIn vitro fertilization

LMPLast menstrual period

MBRSwedish Medical Birth Register

OROdds ratio

RDSRespiratory distress syndrome of the newborn

SGASmall for gestational age

USUltrasound

Electronic supplementary materialThe online version of this article doi:10.1186-s12884-016-1129-z contains supplementary material, which is available to authorized users.

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Autor: Merit Kullinger - Bengt Haglund - Helle Kieler - Alkistis Skalkidou

Fuente: https://link.springer.com/







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