Risk factors for serious morbidity in term nonanomalous neonates

Janine E. Spain, Methodius G. Tuuli, George A. MacOnes, Kimberly A. Roehl, Anthony O. Odibo, Alison G. Cahill

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Objective The purpose of this study was to identify ante- and intrapartum risk factors for serious morbidity in term nonanomalous neonates. Study Design We analyzed the first 5000 subjects within an ongoing prospective cohort study of consecutive term births from 2010-2012. The primary outcome was a composite of serious neonatal morbidity defined as 1 cases of hypoxic ischemic encephalopathy, meconium aspiration with pulmonary hypertension, requirement of hypothermia therapy, respiratory distress syndrome, seizures, sepsis or suspected sepsis, or death. We calculated odds ratios for the composite morbidity that is associated with ante- and intrapartum factors. Multivariable logistic regression was used to estimate adjusted odds ratios. Results Of 5000 term nonanomalous births, 393 had the composite morbidity. Significant risk factors for morbidity were nulliparity, presence of meconium, first stage of labor >95th percentile, second stage of labor >95th percentile, pregestational diabetes mellitus, chronic hypertension, obesity, maternal intrapartum fever, and cesarean delivery. In contrast, induction of labor and gestational age 41 weeks were not associated with significant morbidity. Conclusion We identified several significant risk factors for serious morbidity in term nonanomalous neonates. Clinicians may use these risk factors to help anticipate the potential need for additional neonatal support at delivery.

Original languageEnglish
Pages (from-to)799.e1-799.e7
JournalAmerican journal of obstetrics and gynecology
Issue number6
StatePublished - Jun 1 2015


  • neonatal morbidity
  • risk factor
  • term neonate


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