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Gestational Age, Perinatal Mortality Link Examined

JAMA Pediatrics; ePub 2018 May 14; Ananth, et al

Although the proportion of births at gestational age 39 to 40 weeks increased, perinatal mortality at this gestational age declined, according to a recent retrospective study. This finding, however, may be owing to pregnancies delivered at 39 to 40 weeks that previously would have been unnecessarily delivered earlier, leaving fetuses at higher risk for mortality at other gestational ages. Researchers linked data from live birth and infant death data among >35 million singleton births from January 1, 2007, through December 31, 2015, and found:

  • Among the 34,236,577 singleton live births during the study period, the proportion of births at all gestational ages declined, except at 39 to 40 weeks, which increased (54.5% in 2007 to 60.2% in 2015).
  • Overall perinatal mortality declined from 9.0 to 8.6 per 1,000 births.
  • Stillbirths declined from 5.7 to 5.6 per 1,000 births, and neonatal mortality declined from 3.3 to 3.0 per 1,000 births.
  • Although the proportion of births at gestational ages 34 to 36, 37 to 38, and 42 to 44 weeks declined, perinatal mortality rates at these gestational ages showed annual adjusted relative increases of 1.0%, 2.3%, and 4.2%, respectively.

Ananth CV, Goldenberg RL, Friedman AM, Vintzileos AM. Association of temporal changes in gestational age with perinatal mortality in the United States, 2007-2015. [Published online ahead of print May 14, 2018]. JAMA Pediatrics. doi:10.1001/jamapediatrics.2018.0249.

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