Peer-reviewed article
Neonatal Outcomes Following Preterm Birth Between 28 and 36 Weeks' Gestation in Vietnam: A Cohort Study.
Tran QTT, Seeho SK, Nippita TA, Morris JM, Le TQ et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined outcomes for 5,374 babies born prematurely between 28 and 36 weeks of pregnancy in Vietnam between 2019 and 2020. Babies born before 34 weeks had high rates of illness and death, with outcomes improving as gestational age increased. When preterm birth was planned through induction or caesarean section, babies had more complications than those born through spontaneous labour, though mortality rates were similar. Antenatal corticosteroids were associated with lower death rates but higher illness rates among planned preterm births.
Key points
- More than 90% of neonates born at 28-33 weeks had morbidity, declining from 34 weeks onwards
- Planned preterm births (induction or caesarean) had higher odds of morbidity compared to spontaneous labour (aOR 1.53 and 2.14 respectively)
- Mortality rates showed no significant difference between planned births and spontaneous labour
- Among planned preterm births before 35 weeks, antenatal corticosteroids were associated with lower mortality (2.5% vs 5.1%) but higher morbidity (90.7% vs 74.3%)
- 72.3% of preterm births occurred between 34-36 weeks, with 51.5% following spontaneous labour
Limitations
This is a retrospective cohort study without randomization, so causal inference about the effects of planned versus spontaneous birth is limited. The study does not evaluate a specific intervention but rather observes outcomes across different birth circumstances in one country.
Abstract
Background Preterm birth leads to adverse neonatal outcomes. Data on neonatal outcomes in middle-income settings like Vietnam are lacking. Aims Describe preterm neonatal outcomes in Vietnam. Materials and methods Retrospective cohort study including all live singleton births at 28-36 weeks' gestation in Vietnam from June 2019 to June 2020. Outcomes included neonatal morbidity and mortality and were examined by labour onset and gestational age groups. Logistic regression was used to estimate the odds of neonatal morbidity and mortality following planned birth (labour induction and prelabour caesarean) relative to spontaneous birth. Results Among 5374 live singleton preterm births, 663 (12.4%) occurred between 28 and 31 weeks, 824 (15.3%) between 32 and 33 weeks and 3887 (72.3%) between 34 and 36 weeks; 2765 (51.5%) births followed spontaneous labour and 2616 (48.5%) were planned births. Mortality rates decreased with increasing gestational age. More than 90% of neonates born at 28-33 weeks had morbidity, with the rate of morbidity decreasing from 34 weeks. The odds of mortality were no different following labour induction (aOR 1.22, 95% CI, 0.72-2.09) or prelabour caesarean (aOR 1.04, 95% CI, 0.63-1.73) compared with spontaneous labour. The odds of morbidity were higher among pregnancies following labour induction (aOR 1.53, 95% CI, 1.31-1.80) and prelabour caesarean section (aOR 2.14, 95% CI, 1.84-2.50) than spontaneous labour. Among planned preterm births < 35 weeks, antenatal corticosteroids were associated with higher morbidity (90.7% vs. 74.3%, p < 0.001) and lower mortality rates (2.5% vs. 5.1%, p = 0.022). Conclusions Preterm neonates born before 34 weeks are at particularly high likelihood of morbidity and mortality, with planned preterm birth associated with a higher rate of morbidity.