不同胎龄新生儿心电图心率及各时限特点的研究

目的 观察不同胎龄新生儿心率、P-R、QRS问期及经心率校正后的QT间期(QTLc)的特点,为新生儿心电图诊断提供科学依据.方法 不同胎龄新生儿共142例,按胎龄分为:28～30周组、31～33周组、34～36周组、37～40周组.测量心率、P-R、QRS时限及QTLc.结果 不同胎龄新生儿心率随胎龄增长而减慢,P-R间期相应延长,各组间比较差异有非常显著性(P＜0.01);不同胎龄新生儿QRS间期及QTLc无明显变化.结论 不同胎龄新生儿心率及P-R间期变化与胎龄相关,而QRS间期及QTLc与胎龄无明显相关.     

新生儿呼吸衰竭870例临床流行病学分析

目的探讨聊城市人民医院新生儿重症监护室(NICU)中不同胎龄新生儿呼吸衰竭(NRF)的临床特点,为合理诊治提供依据。方法选择2010—2011年我院NICU收治的NRF患儿,根据胎龄分为≤32周组、33～36周组和≥37周组,对各组新生儿的围产期情况、疾病分布状况、呼吸机辅助通气方式、通气时间、辅助通气并发症、住院时间、费用及预后进行回顾性总结,以反映我院NICU新生儿呼吸危重病的救治状况。结果 2年间我院NICU共收治新生儿3077例,NRF870例,占同期住院患儿的28.3%;主要原发疾病包括新生儿呼吸窘迫综合征(RDS)和(或)严重湿肺398例(45.7%),新生儿肺炎224例(25.7%),新生儿窒息163例(18.7%)。870例患儿中,早产儿502例,占57.7%;痰培养阳性157例,占18.0%;合并持续肺动脉高压99例(11.4%),合并气胸14例(1.6%);治愈558例(64.1%),好转105例(12.1%),死亡47例(5.4%),放弃160例(18.4%);住院时间(14.2±8.8)天。结论 NRF是本院NICU的重要疾病,原发病以RDS和(或)严重湿肺为首,足月儿RDS有增多趋势,与择期剖宫产、羊水污染有关,容易并发持续肺动脉高压,应引起重视。开展针对早产儿及RDS救治的新技术有利于提高NRF的救治成功率,降低病死率。     

产前糖皮质激素对晚期早产儿呼吸系统疾病的影响

目的探讨产前激素应用对晚期早产儿呼吸系统疾病的影响。方法回顾性分析2016年1月至2020年6月娩出的晚期早产儿及其母亲的临床资料。根据母亲产前地塞米松应用情况分为激素组和对照组,比较不同胎龄晚期早产儿呼吸系统疾病发生情况。采用logistic回归分析模型分析晚期早产儿生后呼吸系统疾病发生的危险因素。结果在胎龄36～36~(+6)周组,激素组剖宫产率高于对照组;在胎龄35～35~(+6)周和36～36~(+6)周组,激素组母亲分娩前胎膜早破率低于对照组,差异均有统计学意义(P0.05)。多元logistic回归分析显示,剖宫产、窒息是晚期早产儿呼吸系统疾病发生的危险因素;胎龄越大,呼吸系统疾病的发生风险越低(P0.05)。结论为减少晚期早产儿呼吸系统疾病的发生,应尽量延长孕周,降低剖宫产率,减少窒息的发生。     

新生儿重症湿肺高危因素分析

目的 探讨新生儿重症湿肺的临床特征及需要机械辅助通气治疗的影响因素.方法 对167例新生儿湿肺进行回顾性分析,观察其临床特征、预后,分析需要机械辅助通气治疗的影响因素.结果 167例患儿中早产儿69例(41.2%).161例(96.4%)患儿入院时存在呼吸衰竭,72例(43.1%)需行气管插管机械通气.辅助通气组111例(气管插管72例,经鼻呼气末正压通气39例),非辅助通气组56例.两组患儿在年龄、出生体重、剖宫产率、性别比方面差异无显著性.全部患儿中24例合并心脏疾病,28例合并缺氧缺血性脑病,51例合并吸入性肺炎.湿肺患儿中胎龄<34周(OR=3.398,95%CI:1.113～10.369)及合并心脏疾病(OR=4.122,95%CI:1.173～14.481)者,需辅助通气的危险增加.是否有重度窒息、是否合并缺氧缺血性脑病及吸入性肺炎,未被证实是湿肺患儿需辅助通气的影响因素.结论 早产儿重症湿肺发生率较高,湿肺患儿胎龄<34周及合并心脏疾病时需要机械辅助通气的危险增加.     

不同胎龄及出生体质量早产儿293例临床分析

目的 分析不同胎龄及出生体质量早产儿的早产原因、并发症发生率及死亡原因.方法 将2008年4月至2009年3月在我院新生儿监护室住院的293例早产儿根据出生体质量分为＜1500 g、～2500 g、≥2500 g组;根据胎龄分为≤32周、～34周、～37周组.分析患儿的早产原因,并比较各组患儿并发症的发生率及病死率.结果 (1)早产原因:胎膜早破、妊娠高血压综合征及多胎妊娠为早产的主要原因,上述原因常合并存在.(2)并发症:呼吸系统疾病、喂养不耐受、贫血、代谢性酸中毒的发生率在不同胎龄组间比较差异有统计学意义(P＜0.05),胎龄越小,并发症发生率越高.呼吸暂停、新生儿呼吸窘迫综合征、呼吸衰竭的发生率在不同体质量组间比较差异有统计学意义(P＜0.05),出生体质量越小,呼吸系统疾病发生率越高;肺炎、消化道畸形、新生儿缺氧缺血性脑病、高胆红素血症、电解质紊乱的发生率在不同体质量组间差异有统计学意义(P＜0.05),但出生体质量越大,发生率越高.(3)病死率及死亡原因:本组293例患儿中共死亡15例,病死率5%.胎龄越小、出生体质量越低,病死率越高,各组间比较差异有统计学意义(P＜0.05).15例死亡患儿中除1例治疗无效死亡外,其余14例均因放弃治疗死亡.结论 (1)加强围生期保健、重视产前检查、避免胎膜早破及妊娠高血压综合征的发生,预防早产发生,尤其要避免胎儿在孕32周以前出生.(2)不同的并发症在不同胎龄与出生体质量的早产儿中发生率不同.(3)早产儿死亡原因除与自身发育不成熟有关外,还与家长担心早产儿的远期并发症、经济问题及发育畸形有关.     

新生儿窒息与多脏器损害的临床损害：附168例分析

1995年1月～1997年12月我院新生儿科共收治168例窒息新生儿,现对其脏器损害的情况分析报道如下。 资料与方法 一、一般资料 男102例,女66例;胎龄<37周28例(16.67％),早产儿平均胎龄为35.4周±1.2周;胎龄≥37周140例(83.33％);羊水Ⅱ～Ⅲ°污染56例(33.33％),无污染112例(66.67％);5分钟Apgar评分≤5分47例(27.98％),>5分121例(72.02％);轻度窒息99例(58.93％),重度窒息69例(41.07％)。     

藏族新生儿窒息血清β2微球蛋白及肌酐的变化

新生儿窒息在高原地区仍较常见 ,我院发生率占 43 6 5%。为探讨血清 β2 微球蛋白( β2 ＭＧ)含量与藏族新生儿窒息后肾功能损害的关系 ,进行动态观察血清 β2 ＭＧ及肌酐变化特点 ,旨在说明其对窒息患儿的价值。资料与方法一、对象为我院妇产科 1 997年 1月～ 1 999年 1月分娩活婴 2 2 91名 ,发生窒息 998名 ,窒息发生率 43 6 5% ,本文选择 48例藏族新生儿窒息 ,其中男 2 8例 ,女 2 0例 ,胎龄 >37～ 40周 42例 ,>42周 6例。体重 :<2 50 0ｇ 4例 ,30 0 0～ 350 0ｇ 38例 ,～ 40 0 0ｇ 6例。生后Ａｐｇａｒ评分 :1分钟 4～ 7分 2 4例 ,0～ …     

不同胎龄新生儿心电图T波的特点

目的 观察不同胎龄新生儿心电图T波的特点.方法 不同胎龄新生儿共142例,按胎龄分为4组:28～30周组、31～33周组、34～36周组、37～40周组,观测心电图各导联T波情况.结果 28～30周组、31～33周组、34～36周组、37～40周组Tv1振幅[mV,中位数(四分位数间距)]分另4为-0.10(-0.30～0.10)、-0.10(-0.30～0.15)、-0.10(-0.45～0.25)、0.10(-0.30～0.70),TV1振幅随胎龄增长而增高,各组间差异有显著性(Z=22.535,P=0.000);TV5振幅[mV,中位数(四分位数间距)]分别为0.10(-0.10～0.30)、0.10(-0.20～0.30)、0.15(-0.05～0.25)、0.10(-0.10～0.50),各组间无明显变化,差异无显著性(Z=0.202,P=0.977).I、aVL导联T波低平、倒置及各导联T波均低平现象的发生率随胎龄增长而减少,差异有显著性(P<0.05).结论 不同胎龄新生儿TV1振幅、T波异常率与胎龄增长有相关性,TV5振幅与胎龄增长无相关性.     

胎龄<28周和≥28周超低出生体重儿肠内喂养情况的比较

目的 了解胎龄 < 28周和胎龄≥ 28周超低出生体重儿（extremely low birth weight infant,ELBWI）的肠内喂养情况和喂养不耐受的发生情况。方法 对2018年1月至2020年1月广州医科大学附属第三医院新生儿科收治的ELBWI进行回顾性分析,将其分为胎龄 < 28周组（n=41）和胎龄≥ 28周组（n=38）,比较两组早产儿住院期间的肠内喂养情况和喂养不耐受的发生情况。结果 胎龄 < 28周组41例患儿中,小于胎龄儿占5%（2例）;胎龄≥ 28周组38例患儿中,小于胎龄儿占63%（24例）。胎龄 < 28周组初始和最终达到足量肠内喂养时间均长于胎龄≥ 28周组（P < 0.05）。胎龄 < 28周组的喂养不耐受复发率高于胎龄≥ 28周组（54% vs 32%,P < 0.05）。胎龄≥ 28周组生后1~2周内喂养不耐受发生率（5%）低于胎龄 < 28周组（29%）,且其喂养不耐受持续时间短于胎龄 < 28周组（P < 0.05）。与胎龄 < 28周组比较,胎龄≥ 28周组体重增长速率较高,住院时间较短,支气管肺发育不良发生率较低,但出院时宫外生长发育迟缓率较高（P < 0.05）。结论 与胎龄 < 28周ELBWI相比,胎龄≥ 28周ELBWI的喂养不耐受复发率低,达足量肠内喂养时间早,但宫外生长发育迟缓发生率高,喂养需要更加积极。     

新生儿住院病例244例分析

我院儿科自1975年4月～1984年10月10年内新生儿住院病例共244例;占同期儿科住院总人数12053例的2%。临床资料每例患儿只统计一项主要疾病,以第一诊断为主,不包括合并症,将新生儿分为早产儿、足月儿与过期产组。早产儿组胎龄<37周30例(12.3%),足月儿组胎龄第38周～42周174例(71.3%),过期     

Neonatal complications of extreme prematurity in mechanically ventilated infants

Previous data have suggested that neonatal complications amongst preterm ventilated infants increase with decreasing gestational age and thus are likely to be greatest among ventilated infants of less than 28 weeks gestational age. The aim of this study was to test that hypothesis, thus we report the neonatal complications of 175 extremely preterm mechanically ventilated infants (gestational age 28 weeks). Of the infants 152 were ventilated because of respiratory distress syndrome (RDS) or respiratory distress of severe prematurity, 41% of these infants died. Amongst infants with RDS or respiratory distress of extreme prematurity, mortality was significantly increased in infants of gestational age 24 weeks and birth weight 1000 g. In this group 20% developed a pneumothorax, and mortality was inversely related to gestational age. In infants with RDS, 43% developed a periventricular haemorrhage and 37% were still oxygen-dependent at 28 days of age; neither of these complications was significantly related to birth weight or gestational age. Of infants with RDS 38% developed a patent ductus arteriosus and 16% developed retinopathy of prematurity. These data suggest that even amongst very immature infants there has been an impressive reduction in the neonatal complications of mechanical ventilation.     

Hyaline membrane disease in full-term neonates.]

OBJECTIVES: Evaluation of the consequences of preplanned delivery near term on the neonatal respiratory distress syndrome and its mechanism of occurrence. PATIENTS AND METHODS: During five years, full-term infants (> or =37 weeks gestational age) admitted in the Institut de Puericulture de Paris, with a well characterized hyaline membrane disease, were included in a retrospective study. RESULTS: During this period, 97 full-term neonates with respiratory distress syndrome were hospitalized in the neonatal intensive care unit. The diagnosis of hyaline membrane disease was made in view of clinical and radiological criteria. The study of mode of delivery has shown a high frequency of pre-planned delivery: 54% caesarean and 24% vaginal delivery. A high-risk of occurrence of hyaline membrane disease was identified around 37 weeks gestational age in the case of preplanned delivery. CONCLUSION: Preplanned delivery near 37 weeks gestational age may increase the risk of occurrence of hyaline membrane disease in full-term neonates.     

足月新生儿呼吸窘迫综合征危险因素及肺表面活性物质疗效评估

目的探讨足月新生儿呼吸窘迫综合征（RDS）的危险因素,观察肺表面活性物质（PS）的疗效,为足月儿RDS的防治提供依据。方法选取2007年1月至2011年12月郑州大学第三附属医院NICU收治的足月儿RDS为RDS组,以同期入院的非RDS足月儿为对照组,对两组性别、胎龄、分娩方式、宫内窘迫、出生窒息、母亲妊高症、糖尿病、胎膜早破进行单因素方差分析和Logistic多因素回归分析;并以RDS组中是否给予PS治疗分为应用PS亚组和未应用PS亚组,评估PS的疗效。结果RDS组和对照组各106例进入分析。 ①RDS组发病时间为生后5 min至18 h,平均（4.9±3.4）h,其中生后6 h内发病87例（82.1%）,~12 h 16例（15.1%）,>12 h 3例（2.8%）;X线胸片分级Ⅰ级28例（26.4%）,Ⅱ级36例（34.0%）,Ⅲ级23例（21.7%）,Ⅳ级19例（17.9%）;②Logistic回归分析显示男性(OR=10.35, 95%CI:1.94~15.26)、胎龄<39周(OR=6.59,95%CI:2.33~36.51)、剖宫产(OR=7.26,95%CI:11.61~23.22)、择期剖宫产(OR=13.14,95%CI:3.55~21.84)和出生窒息(OR=4.33,95%CI: 2.74~27.39)是足月儿RDS的危险因素;③应用PS亚组72例,未应用PS亚组34例。机械通气发生率、机械通气天数、氧疗时间、住院天数和呼吸机相关性肺炎发生率应用PS亚组均显著低于未应用PS亚组（P<0.05）;两亚组气胸、肺出血、持续性肺动脉高压和动脉导管未闭发生率差异均无统计学意义（P>0.05）。结论男性、胎龄<39周、剖宫产尤其是无医学指征的择期剖宫产、出生窒息是足月儿RDS的危险因素,PS治疗足月儿RDS疗效较好。     

不同年代新生儿肺动脉高压的临床病因分析

目的 研究不同年代影响新生儿肺动脉高压发生的临床病因与病情发展的关系.方法 回顾性分析2006年6月至2012年5月北京儿童医院NICU收治的169例肺动脉高压患儿的临床资料,按时间顺序分为前期组79例（2006年6月至2009年5月）及后期组90例（2009年6月至2012年5月）,分别统计患儿的性别、胎龄、原发病、心脏超声检查情况.分析不同年代肺动脉高压患儿的主要临床病因及病情.结果 前期组入院时间（2.15±1.2）d,晚于后期组（1.41±0.7）d;前期组原发病中胎粪吸入综合征25例（31.6％）,后期组14例（15.6％）,两组差异有统计学意义（P＜0.05）.其他原发病如先天性膈疝、新生儿呼吸窘迫综合征、吸人性肺炎、湿肺、新生儿感染性肺炎/败血症、新生儿窒息两组间差异无统计学意义（P＞0.05）.前期组早产儿11例（13.9％）,后期组早产儿23例（25.6％）,两者间差异有统计学意义（P＜0.05）.足月儿与过期产儿两组间差异无统计学意义（P＞0.05）.入院后进行床边超声心动图检查,轻度及中度肺动脉高压两组差异无统计学意义（P＞0.05）.发生重度肺动脉高压的患儿前期组较后期组明显增多（26例vs 17例）.结论 随着我国围生期监测及产时复苏技术的提高,由胎粪吸入综合征引起的肺动脉高压并转入上级医院救治的患儿有所减少.早产儿中发生肺动脉高压的比例有所增加,肺动脉高压患儿转入NICU的时间缩短,从而发生重度肺动脉高压的患儿相对减少,给治疗及改善预后提供了有力支持.     

Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery

AIM: To establish whether the timing of delivery between 37 + 0 and 41 + 6 wk gestation influences neonatal respiratory outcome in elective caesarean delivery, following uncomplicated pregnancy, thus providing information that can be used to aid planning of elective delivery at term. METHODS: All pregnant women who were delivered by elective caesarean delivery at term during a 3-y period were identified from a perinatal database and compared retrospectively with pregnant women matched for week of gestation, who were vaginally delivered. Maternal characteristics, neonatal outcome, incidence of respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN) were analysed. During this time, 1284 elective caesarean section deliveries occurred at or after 37 + 0 wk of gestation. RESULTS: Neonatal respiratory morbidity risk (odds ratio, OR), including RDS and TTN, was significantly higher in the infant group delivered by elective caesarean delivery compared with vaginal delivery (OR 2.6; 95% CI: 1.35-5.9; p < 0.01). While TTN risk in caesarean delivery was not increased (OR 1.19; 95% CI: 0.58-2.4; p > 0.05), the RDS risk was significantly increased (OR 5.85; 95% CI: 2.27-32.4; p < 0.01). This RDS risk is greatly increased in weeks 37 + 0 to 38 + 6 (OR 12.9; 95% CI: 3.57-35.53; p < 0.01). After 39 + 0 wk, there was no significant difference in RDS risk. CONCLUSIONS: Infants born by elective caesarean delivery at term are at increased risk for developing respiratory disorders compared with those born by vaginal delivery. A significant reduction in neonatal RDS would be obtained if elective caesarean delivery were performed after 39 + 0 gestational weeks of pregnancy.     

正常足月新生儿振幅整合脑电图特点的多中心研究

目的探讨正常足月新生儿生后3 d内振幅整合脑电图（aEEG）的特点,为新生儿临床脑功能监测提供依据。方法选择各参研医院母婴同室或新生儿室的正常足月新生儿为研究对象,依据胎龄分为37周～、38周～、39周～、40周～和41～42周胎龄组。采用首台国产aEEG仪记录正常足月新生儿生后1、2和3日龄的aEEG,每次记录3 h。采用半对数公式计算电压,分析正常足月新生儿aEEG背景波、电压、睡眠-觉醒周期及其影响因素。结果2008年5月至2009年5月纳入116名正常足月新生儿。①正常足月新生儿aEEG背景波呈现连续性波形。905％（105/116名）在生后1日龄出现睡眠-觉醒周期,所有正常足月新生儿在生后2日龄均出现睡眠-觉醒周期;②1个睡眠-觉醒周期的平均持续（699±187）min,其中宽带平均为（220±57）min,窄带平均为（479±171）min;③正常足月新生儿生后1、2和3日龄aEEG背景波最低电压分别为（128±34）、（121±20）和（125±26）μV,最高电压分别为（375±110）、（384±94）和（386±96）μV;④日龄、性别、分娩方式及母亲妊娠并发症对正常足月新生儿aEEG的宽带、窄带电压和时程均无显著影响,37周～胎龄组生后1～3日龄aEEG窄带电压上界较38～42周各胎龄组显著增高（P分别为0014,0001和0000）。结论正常足月新生儿aEEG背景波为连续波形,存在明显的睡眠-觉醒周期;最低电压均＞5 μV,最高电压均＞10 μV。37周～胎龄组的正常足月新生儿生后1～3日龄aEEG窄带电压上界较38～42周各胎龄组正常足月新生儿显著增高。正常足月新生儿的aEEG表现不受日龄、性别、分娩方式及母亲妊娠并发症的影响。     

惠州地区不同胎龄早产儿甲状腺功能检测及影响因素分析

目的 探讨不同胎龄早产儿甲状腺功能特点及其影响因素。方法 选择本院新生儿科2012年1~12月收治的早产儿为研究对象。按胎龄分为28~31周组、32~34周组及35~36周组,选取同期本院产科出生的健康足月新生儿30名为对照组。分别在生后第1天和第14天检测新生儿静脉血血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺激素（FT4）以及促甲状腺激素（TSH）,并分析其影响因素。结果 各组新生儿生后14天血清FT3、FT4、TSH水平均显著低于生后第1天（P〈0.05）。35~36周组和对照组生后第1、14天血清FT3、FT4水平均高于28~31周组和32~34周组,32~34周组高于28~31周组（P〈0.05）。TSH水平生后第1天35~36周组和对照组高于28~31周组和32~34周组,生后第14天28~31周组和32~34周组高于35~36周组和对照组（P〈0.05）。早产儿生后第1天影响甲状腺功能的因素为胎龄、出生体重及窒息、缺氧缺血性脑病、呼吸窘迫征综合征、休克等严重疾病;生后第14天影响因素为胎龄和出生体重。结论 早产儿下丘脑-垂体-甲状腺轴发育不成熟,生后14天检测甲状腺功能具有重要临床意义。     

早产儿早期血清降钙素原与绒毛膜羊膜炎程度相关性分析

目的　探讨早产儿早期血清降钙素原（procalcitonin,PCT）与胎盘组织学绒毛膜羊膜炎（histological chorioamnionitis,HCA）程度的相关性。方法　回顾性选取2016年1月至2018年1月在银川市妇幼保健院产科出生并于生后2h内转入新生儿科的早产儿197例,根据胎盘病理检查结果分为HCA阳性组与阴性组,并根据绒毛膜羊膜炎分度标准分为轻度、中度及重度组,比较各组间的临床资料及实验室检查结果,探讨早产儿早期血清PCT水平与HCA程度的相关性,并判断其在预测早期感染的临床价值。结果　HCA病理改变组的胎龄、出生体重较正常组低,PCT及总胆红素（total bilirubin,TB）较正常组高,差异有统计学意义（P<0.05）;两组间性别、民族、全血白细胞（white blood cell,WBC）、中性粒细胞绝对值（neutrophil,NEUT）及C反应蛋白（C-reactive protein,CRP）差异无统计学意义（P>0.05）。不同程度HCA组在胎龄、WBC、CRP、PCT水平之间均有统计学具有统计学意义（P均<0.05）,其中重度HCA组与轻度HCA组在胎龄、PCT、WBC差异具有统计学意义（P<0.01）;HCA阳性早产儿组的胎龄与早期血清PCT水平存在负相关（r=-0.221,P<0.05）,血清CRP水平与血清PCT水平存在正相关（r=0.445,P<0.01）;早产儿入院血清PCT水平对判断宫内感染的灵敏度为52.3,特异度为82.5。生后2 h内的PCT水平在新生儿呼吸窘迫综合征时升高（P<0.05）。结论　早产儿早期血清PCT水平随HCA炎症程度加重而升高,可作为早期判断是否存在宫内感染及部分新生儿感染性疾病的生化指标。PCT在新生儿呼吸窘迫综合征时升高,呼吸困难、胎龄及CRP值可影响HCA阳性早产儿的PCT水平。     

Duration of ductal shunting in healthy preterm infants: an echocardiographic color flow Doppler study

The purpose of this investigation was to assess the duration of ductal shunting after birth in healthy preterm infants (30 to 37 weeks gestational age) without evidence of respiratory distress. Thirty-six infants were evaluated in the first 12 hours of life by means of two-dimensional echocardiography and color flow Doppler techniques, and then once daily until no ductal flow was detected (defined as functional closure). Preterm infants were subdivided into two groups by gestational age: group 1 = 30 to 33 weeks (n = 12); group 2 = 34 to 37 weeks (n = 24). Sixteen full-term infants (38 to 41 weeks) were similarly evaluated as control subjects (Group 3). One infant from each group had a closed ductus at the time of the first study (performed at a mean of 7.7 +/- 3.2 hours). Subsequent studies for the entire group were performed at a mean of 31.3 +/- 5.4 hours (day 2), 55.0 +/- 4.5 hours (day 3), and 80.3 +/- 6.1 hours (day 4). For the three groups, the rates of ductal closure ranged from 50.0% to 58.3% on day 2 and 81.3% to 87.5% on day 3. For the entire group, all but one infant had demonstrated closure of the ductus arteriosus by day 4. Within the range of gestational ages studied, we conclude that prematurity, in the absence of respiratory distress syndrome, does not prolong the initial duration of physiologic ductal shunting.     

Late better than early elective term Cesarean section

Aim: Caesarean section (CS) deliveries have increased, mostly because of patient/obstetrician preference. Although CS decreases the risk of delivery‐related injuries, it increases the risk for respiratory and neurological complications. Complication rates are reportedly higher for elective CSs for term infants performed at 37–38 gestational weeks than later. We investigated this difference in an Israeli cohort. Methods: Data on all births in our medical centre during 2007–2009 were reviewed. Those on elective CSs for term infants were retrieved and divided into ‘early’ (37–38 gestational weeks) or ‘late’ (week 39 or later) groups whose epidemiological and outcome characteristics were compared. Result: Of the 12 276 births, 596 were early and 454 were late elective CSs. There were no differences in gender, ethnicity, Apgar score or length of hospital stay. Twenty‐six infants from the early group and 11 infants from the late group were transferred to the neonatal intensive care unit. Within them, compared with all elective CSs, the morbidity rate was higher for the former infants than for the latter. Conclusion: Morbidity was higher among infants who were delivered at 37–38 gestational weeks by elective CS. We recommend postponing elective CSs to ≥39 weeks.