Obstetrical outcomes amongst preterm singleton births

OBJECTIVE: The purpose of this study was to review the outcome of preterm singleton neonatal morality based on birthweight and gestational age at delivery.

METHODS: A retrospective review of hospital case notes of maternity data and neonatal mortality data was carried out on all singleton preterm deliveries from 26 to <37 completed weeks between 1996 and 1999 to investigate neonatal death.

RESULTS: There were 20,758 live-born singleton deliveries over the study period, of which 638 were preterm (3%). The overall neonatal mortality in the preterm group was 42/1000. The neonatal mortality rate fell with advancing gestational age from 174/1000 live births at 28 weeks to 37/1000 live births at <37 completed weeks of gestation. The neonatal mortality rate also fell with increasing birth-weight from 285/1000 live births of 1000g to 14/1000 live births at 2500g. There was a significant increase in the proportion of babies delivered spontaneously.

CONCLUSION: This study has demonstrated neonatal mortality using gestational age and birth weight. The results will be of use in obstetric management when elective preterm delivery is considered, and for providing prognostic guidance following preterm delivery.