Pregnancies Delivered At Range 37 Weeks

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Pregnancies Delivered At Range 37 Weeks

Pregnancies Delivered At Range 37 Weeks

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GTPAL stand for: gravida, term, preterm, abortions, living

Gravida: how many pregnancies a woman has had. Term how many pregnancies delivered that have reached or surpassed 37 weeks.

Term: deliver at 37 or greater weeks

Preterm: how many pregnancies between 20-37 (actually 36 and 6/7) wks

Abortion: pregnancy loss at less than 20 weeks. Abortions may also be induced by physicians or spontaneously.

Living: how many children are living now?:

***Multiple births (twins, triplets and higher multiples) count as one birth

1. This is mom’s 1st pregnancy:

2. 2nd pregnancy and she had an AB at 8 wks for the 1st pregnancy

3. 3rd pregnancy. 1st pregnancy delivered at 38 and 2nd pregnancy was twins delivered at 29 wks. 1 of those children died.

4. 2nd pregnancy. Delivered twins at 37 wks both live pregnancy.

5. 3rd pregnancy. Delivered triplets at 28 wks and 2 of the babies survived. Had an elective AB at 6 wks.

6. This is a woman’s 5 pregnancies,  births at 41 week, 39 5/7 weeks, 38 6/7 and 36 5/7 weeks 1 induced abortion at 10 weeks , and 4 living children at this time.

7. a pregnant woman who carried one pregnancy to term with a surviving infant; carried one pregnancy to 35 weeks with surviving twins; carried one pregnancy to 9 weeks as an ectopic (tubal) pregnancy; and has 3 living children would have a GTPAL annotation of?

8. A woman who has given birth at term once and has had one miscarriage at 12 weeks would be recorded as?

Rubric:

This assignment is worth 5 points. 1 point for APA and style of paper.

.5 point for each of the eight cases. Partial points are not awarded if you get part of a case incorrect you get the whole case incorrect.  Use page 259 in your text book for further details. Explain your rationale. Demonstrations will be done in class.

Advances in obstetric care have been accompanied by increasing rates of intervention which often involve elective delivery at 37 weeks, soon after term gestation has been achieved.

AIM:
The aim of this study was to examine the behavioural sequelae for children born at this early term gestational age compared with those born at later weeks.

METHODS:
The Western Australian Pregnancy Cohort (Raine) Study provided comprehensive obstetric data from 2900 pregnancies. Offspring were followed up at ages two, five, eight, 10, 14 and 17 years using the parent report Child Behaviour Checklist (CBCL) with clinical cutoffs for overall, internalising (withdrawn, somatic complaints, anxious/depressed) and externalising (delinquent, aggressive) behaviour (T-score ≥ 60). We used longitudinal logistic regression models incorporating generalised estimating equations (GEE) with step-wise adjustment for ante-, peri- and postnatal confounding factors.

RESULTS:
Approximately 9% of our cohort was born within the range of 37(0/7) and 37(6/7)  weeks. Those born at 37 weeks’ gestation were at increased risk for overall (OR = 1.43, 95% CI = 1.02, 2.01) and externalising (OR = 1.42, 95% CI = 1.01, 2.01) behavioural problems in the fully adjusted model when compared with infants born from 39 weeks onwards. Infants born late preterm (34-36 weeks) and at 38 weeks did not show a significantly increased risk for behavioural problems.

CONCLUSION:
Infants born at 37 weeks’ gestation are at increased risk for behavioural problems over childhood and adolescence compared with those born later in gestation. We suggest that 37 weeks’ gestation may not be the optimal cutoff for defining perinatal risk as it applies to behavioural development.

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