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Neonatal morbidity according to gestational age and birth weight from five tertiary care centers in the United States, 1983 through 1986

  • Author Footnotes
    a From the Department of Obstetrics, Gynecology and Reproductive Sciences, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
    Patricia A. Robertson
    Correspondence
    Reprint requests: Patricia A. Robertson, MD, Department of Obstetrics and Gynecology, University of California, Box 0346, San Francisco, CA 94143-0346.
    Footnotes
    a From the Department of Obstetrics, Gynecology and Reproductive Sciences, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
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  • Author Footnotes
    b From the Department of Pediatrics, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
    Susan H. Sniderman
    Footnotes
    b From the Department of Pediatrics, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
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  • Author Footnotes
    a From the Department of Obstetrics, Gynecology and Reproductive Sciences, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
    Russell K. Laros Jr.
    Footnotes
    a From the Department of Obstetrics, Gynecology and Reproductive Sciences, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
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  • Author Footnotes
    c From the Departments of Information Technology Services, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
    Ronald Cowan
    Footnotes
    c From the Departments of Information Technology Services, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
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  • Author Footnotes
    d From the Departments of Epidemiology and Biostatislics, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
    David Heilbron
    Footnotes
    d From the Departments of Epidemiology and Biostatislics, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
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  • Author Footnotes
    e University of California Medical Center at San Francisco, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
    Robert L. Goldenberg
    Footnotes
    e University of California Medical Center at San Francisco, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
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  • Author Footnotes
    f the Department of Obstetrics and Gynecology, Ohio State University College of Medicine
    Jay D. Iams
    Footnotes
    f the Department of Obstetrics and Gynecology, Ohio State University College of Medicine
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  • Author Footnotes
    g the Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Sciences Center at Houston
    Robert K. Creasy
    Footnotes
    g the Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Sciences Center at Houston
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  • Author Footnotes
    a From the Department of Obstetrics, Gynecology and Reproductive Sciences, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
    b From the Department of Pediatrics, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
    c From the Departments of Information Technology Services, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
    d From the Departments of Epidemiology and Biostatislics, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
    e University of California Medical Center at San Francisco, the Department of Obstetrics and Gynecology, University of Alabama School of Medicine
    f the Department of Obstetrics and Gynecology, Ohio State University College of Medicine
    g the Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Sciences Center at Houston
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      Objectives: This study details the incidence, by gestational age and birth weight, of specific neonatal morbidities in singleton neonates without major congenital anomalies.
      Study Design: Data were prospectively collected on all deliveries at five tertiary centers in the United States during the years 1983 through 1986. Pregnancies were meticulously dated and the gestational ages of the neonates at delivery were confirmed by Dubowitz score.
      Results: The incidence of respiratory distress syndrome gradually decreases with increasing gestational age until 36 weeks. A marked decrease in the incidence of necrotizing enterocolitis, patent ductus arteriosus, intraventricular hemorrhage, and sepsis occurs after 32 completed weeks. The number of days of mechanical ventilation for respiratory distress syndrome and newborn stay in the tertiary care facility also were significantly reduced after 32 weeks.
      Conclusions: The incidence of both respiratory distress syndrome and patent ductus arteriosus is markedly decreased by both increasing gestational age and birth weight. The incidence of grade III and IV intraventricular hemorrhage, necrotizing enterocolitis, and sepsis virtually vanishes after 34 weeks. These data relating neonatal morbidities to gestational age are important to the obstetrician in the critical decision regarding the timing of delivery and to the parents, who can benefit from a realistic prediction of the neonatal course.

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