AUTHOR=Fayed Amel , Wahabi Hayfaa A. , Esmaeil Samia , Elmorshedy Hala , AlAniezy Hilala 

TITLE=Preterm, early term, and post-term infants from Riyadh mother and baby multicenter cohort study: The cohort profile

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.928037

DOI=10.3389/fpubh.2022.928037

ISSN=2296-2565

ABSTRACT=Background:
Birth before 37 or beyond 42 gestational weeks is associated with adverse neonatal and maternal outcome. Studies investigating determinants and outcomes of these deliveries are scarce. The objective of this study was to determine neonatal birth profile  in relation to the gestational age at delivery and to evaluate its influence on the immediate maternal and neonatal outcomes.
Methods:
This is a multicenter cohort study of 13,403 women conducted at three hospitals in Riyadh. Collected data included sociodemographic characterestics, obstatric history, physical and laboratory measurements. Regression models were developed to estimate adjusted odds ratio (OR) and confidence intervals (CI) to determine factors associated with preterm, early term and post-term births, and  to  evaluate common maternal and neonatal  risks imposed by deliveries outside the fullterm.
Results:
The incidence of preterm, early term, and post-term delivery was; 8.4%, 29.8%, and 1.4% respectively. Hypertensive events during pregnancy consistently increased the risk of all grades of preterm births; from more than threefold for late preterm (OR= 3.40, 95% CI= 2.21-5.23) to nearly sevenfold for extremely early preterm (OR=7.11, 95% CI=2.24-22.60). Early term was more likely to occur in older mothers (OR=1.30, 95% CI =1.13-1.49), grand multiparous (OR=1.21, 95% CI=1.06-1.38) pregestational diabetes (OR=1.91, 95% CI=1.49-2.44), and gestational diabetes (OR=1.18, 95% CI= 1.05-1.33). The risk of post-term birth was higher in primiparous. In preterm, The adverse outcome of  neonates having APGAR<7 at 5 minutes and admission to neonatal intensive care units increased progressively as the gestational age decreased. Post-term births are twofold more likely to need induction of labour, meanwhile, preterm births were more likely to deliver by cesarean section.
Conclusion:
This large cohort study was the first in Saudi Arabia to assess the delivery profile across a continuum of gestational age and the associated maternal and neonatal adverse outcomes of deliveries outside full term period. The study showed that prevalence of preterm and post-term birth in Saudi Arabia are similar to the prevalence in other high-income countries. The immediate adverse pregnancy outcomes inversely increased with the decrease of gestational age at delivery additionally, maternal age, hypertension, diabetes and parity influence the gestational age at delivery.