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KMID : 0606620070030030188
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Korean Journal of Fetal Medicine
2007 Volume.3 No. 3 p.188 ~ p.195
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Neonatal Outcomes following Etiologic Factors of Preterm Birth
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Son Young-Sil
Jeong Dae-Hoon
Seo Young-Jin
Kim Young-Nam
Sung Moon-Su
Kim Ki-Tae
Byun Jung-Mi
Kim Jong-Hyuk
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Abstract
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Objective: To assess the neonatal mortality and morbidity in infants with variant etiologies of preterm birth.
Methods: A study was conducted for 403 neonates born between 28 weeks and 34 weeks at Inje University Busan
Paik Hospital from January 1, 1997 to December 31, 2004. Patients were divided into 5 groups according to the
etiology of preterm birth; preterm labor, premature rupture of membrane (PROM), preeclampsia, placenta previa and
placenta abruption. We evaluated the perinatal mortality and morbidity at each group.
Results: When the preterm births were divided by the etiology, PROM (n=168) was the most frequent group,
followed by preterm labor (n=106), preeclampsia (n=80), placenta previa (n=22) and placenta abruption (n=16). The
maternal age, gestational age and parity were not different among the groups, but prenatal steroid use was significantly
decreased in placenta abruption (18.8%), preterm labor (29.2%) and placenta previa (40.9%) group (p<0.0001). Neonatal
birth weight was the lowest in preeclampsia group as 1410 gm (p<0.0001). The neonatal mortality showed higher rate
in the group of placenta abruption (375/1,000) and placenta previa (318.2/1,000), but relatively lower rate in preterm
labor (150.9/1,000), preeclampsia (150/1,000) and PROM (89.3/1,000) group (p=0.0023). Respiratory distress syndrome
(RDS), especially severe RDS, showed higher incidence in the group of placenta abription (37.5%) and placenta previa
(27.3%) than other groups (p=0.0009). Sepsis, disseminated intravascular coagulation (DIC) and necrotizing enterocolitis
showed the highest morbidity rate in the group of preeclampsia (61.3%, 51.3%, 8.8%, respectively). There were no
significant difference in the morbidity of neonatal cerebral leukomalacia and intraventricular hemorrhage in each groups.
Conclusion: There were differences in neonatal mortality and morbidity according to various reasons of preterm
birth. High neonatal mortality rate was shown in placenta previa and placenta abruption group and low neonatal
mortality in PROM group. When we consider the relation between the low usage of prenatal steroid and severe RDS
in placenta previa and placenta abruption group, it is possible to presume that use of prenatal steroid has great effect
on prognosis of preterm baby.
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KEYWORD
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Preterm birth, Etiologic factors, Neonatal mortality, Neonatal morbidity
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