TO SEE FETAL OUTCOMES IN PRE TERM BIRTH (GESTATIONAL AGE 34 TO 36 WEEK 6 DAYS) WHO DO NOT RECEIVE ANTENATAL CORTICOSTEROIDS
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Keywords
Late preterm, antenatal corticosteroids, neonatal outcomes, respiratory distress, NICU admission.
Abstract
Introduction: Late preterm birth, defined as delivery between 34 weeks and 36 weeks 6 days, is associated with increased neonatal complications. Antenatal corticosteroids (ACS) are known to improve outcomes in preterm births, yet their use in late preterm deliveries remains variable, especially in resource-limited settings. Guidelines, such as the Irish National SOGP Guideline, often do not recommend ACS for this gestational age due to favorable outcomes in well-resourced settings.
Objective: To evaluate neonatal outcomes in late preterm births (34–36+6 weeks) without ACS exposure in a resource-limited setting.
Materials and Method: This observational study was conducted at a secondary care hospital / Civil Hospital Mirpurkhas in Pakistan from January to June 2024. A total of 180 women who delivered between 34 and 36+6 weeks without ACS administration were enrolled. Neonatal outcomes within the first 7 days were documented, including respiratory distress, NICU admission, feeding difficulties, and early neonatal death.
Results: Infants born before 35 weeks had significantly higher rates of respiratory distress (72.9%), NICU admission (81.3%), and hypoglycemia. Neonatal mortality was 5%, with all deaths occurring before 36 weeks.
Conclusion: the absence of ACS in late preterm births correlates with adverse neonatal outcomes, particularly before 35 weeks, supporting targeted ACS use in resource-limited settings despite differing international guidelines. This contrasts with the Irish National SOGP Guideline, which reports favorable outcomes without ACS in well-resourced settings due to neonatal care.
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Dr Areesha Qamar
Department of Obstetrics & Gynaecology, FCPS, Districts Head Quater/ Civil Hospital Mirpurkhas, Pakistan
Dr Saana
Department of Obstetrics & Gynaecology, FCPS, Districts Head Quater/ Civil Hospital Mirpurkhas, Pakistan
Dr Gul Saba Taj
Department of Obstetrics & Gynaecology, FCPS, Pak Oman Hospital Pasni, Pakistan
Dr Sawina
Department of Obstetrics & Gynaecology, FCPS, Districts Head Quater/ Civil Hospital Mirpurkhas, Pakistan
Dr Sania Murad
Department of Obstetrics & Gynaecology, FCPS, CHPE, Christian Hospital Quetta, Pakistan