Perinatal morbidity

Epidemiological studies identify birth after 41 weeks or after 42 weeks as a risk factor for a variety of adverse neonatal outcomes. Caughey et al. [28] conducted a retrospective, cohort study of all low-risk, term, cephalic, and singleton births that were delivered at the University of California, San Francisco, between 1976 and 2001. The incidence of adverse neonatal mortality outcomes at 40, 41 and 42 weeks' gestation was examined in a multivariate analysis and compared with the rates in pregnancies that were delivered at 39 weeks of gestation, after controlling for maternal demographics, length of labour, induction, mode of delivery, and birth weight (except macrosomia). Compared with the outcome at 39 weeks' gestation, the relative risk of meconium aspiration increased significantly from 2.18 at 40 weeks to 3.35 at 41 weeks and 4.09 (95% CI 2.07-8.08) at 42 weeks. A composite outcome of 'severe neonatal complications' including skull fracture and brachial plexus injuries, neonatal seizures, intracra-nial haemorrhage, neonatal sepsis, meconium aspiration syndrome, and respiratory distress syndrome, increased from a relative risk of 1.47 at 40 weeks to 2.04 at 41 weeks to 2.37 (95% CI 1.63-3.49) at 42 weeks.

A strong association between neonatal seizures and delivery at 41 weeks' gestation or more has been identified in previous case control studies. Minchom et al. [29] found that delivery after 41 weeks' gestation was associated with an odds ratio of 2.7 (95% CI 1.6-4.8). Curtis et al. [30] studied 89 babies with early neonatal seizures delivered after 42 weeks' gestation in Dublin. Twenty-seven were delivered after 42 weeks' gestation compared with 6 of 89 controls (odds ratio 4.73; 95% CI 2.22-10.05).

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Getting Back Into Shape After The Pregnancy

Getting Back Into Shape After The Pregnancy

Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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