Implications of maternal health status on term and close to term neonates in a socioeconomically high-risk population

Abstract

Objective

To investigate maternal morbidities and their implications on term neonates in a socioeconomically underprivileged population.

Methods

In a retrospective population-based study, maternal morbidities were associated with neonatal birth weight (BW), gestational age (GA), Apgar scores, respiratory distress (RD), admission to Neonatal intensive care nursery (NICU), feeding difficulties, and the length of hospital stay (LOS) in infants admitted to the level 1 nursery via multivariate regression analyses.

Results

In the 508 mother-infant pairs, 61.4% were Hispanic, 18.4% were African American, 9.6% were non-Hispanic white, and 10.6 % were Asian/Pacific islanders. 8.7% of the neonates [GA 38.63 (1.3) weeks and BW 3196.3 (574.6) g] had Apgar scores <7 at 1 and 2.2% at 5 minutes of life. The prevalence of maternal hypertension (8.5%), Preeclampsia-eclampsia (10.1%), Apgar scores <7 (8.7, 2.2 % at 1 and 5 minutes), NICU admission (20.4%), and feeding difficulty (7.5%) were higher than reported. Mean LOS at 4.29 days was higher than documented in term infants. Apgar scores were associated with eclampsia/preeclampsia, C-section, and antepartum hemorrhage; NICU admission with chorioamnionitis, C-section, and substance abuse; feeding difficulties with maternal alcohol consumption; and longer LOS with preeclampsia/eclampsia, chorioamnionitis, C-section, and tobacco abuse. Maternal hematocrit had positive associations with BW and GA and negative associations with LOS, feeding difficulties, and NICU admission rates.

Conclusions

In the underprivileged multiethnic maternal-neonatal population, term neonates exhibited low-intensity complications attributable to adverse maternal conditions. Optimizing maternal hematocrit may improve neonatal birth weight and maturational status and decrease adverse outcomes.