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Published November 04, 2013, 12:56 PM

Pregnancy terms changed to improve newborn health

FARGO – Women in the last few weeks of pregnancy now may have to wait a bit longer before delivering their babies, at least for elective deliveries.

By: Tracy Frank, INFORUM

FARGO – Women in the last few weeks of pregnancy now may have to wait a bit longer before delivering their babies, at least for elective deliveries.

The American College of Obstetricians and Gynecologists (The College) and the Society for Maternal-Fetal Medicine have redefined ‘term pregnancy’ into four new categories: early term (between 37 weeks and 38 weeks, six days), full term (between 39 weeks and 40 weeks 6 days), late term (between 41 weeks and 41 weeks 6 days), and postterm (beyond 42 weeks.)

The point of the change is to improve newborn health by preventing elective deliveries before 39 weeks of gestation, according to a news release from The College.

“This terminology change makes it clear to both patients and doctors that newborn outcomes are not uniform even after 37 weeks,” said Dr. Jeffrey L. Ecker, chairman of The College’s Committee on Obstetric Practice in a news release. “Each week of gestation up to 39 weeks is important for a fetus to fully develop before delivery and have a healthy start.”

Estimated delivery dates are calculated 40 weeks from the first day of a pregnant woman’s last menstrual period.

Babies used to be considered ‘term’ if they were born anytime between three weeks before and two weeks after the estimated delivery date.

“Until recently, doctors believed that babies delivered in this five-week window had essentially the same good health outcomes,” Ecker said.

Research shows that every week of gestation impacts newborns’ health. The last few weeks of pregnancy allow a baby’s brain and lungs to fully mature. Babies born between 39 weeks and 40 weeks 6 days have the best health outcomes, the news release stated.

Planned deliveries before 39 weeks should only occur when there are significant health risks to the mother or baby in continuing the pregnancy, Ecker said.

“This has been the standard of care, but the data wasn’t as clear until recently,” said Dr. Joyoti Saha, a Sanford Health obstetrician/gynecologist. “Now it’s pretty clear in terms of the benefits.”

By waiting a bit for elective inductions and caesarian sections, doctors hope babies will have fewer lung issues like pneumonia and respiratory failure and fewer admissions to the neonatal intensive care unit, Saha said.

“The idea is that there’s significantly less morbidity,” she said.

Doctors would not try to stop a delivery that is happening naturally after 34 weeks, Saha said.

“I think it’s great,” Saha said of the new classifications. “It helps physicians when there’s clear terminology in place and clear guidelines.”

Readers can reach Forum reporter Tracy Frank at (701) 241-5526

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