Mother’s Physical Health Before Delivery Matters: What Happens and Why?

  • Jennifer Marandola
  • Gisela Becker


There has been a significant rise in late preterm births globally [1]; it is the leading cause of death in children under the age of 5 years [2]. Disparities in survival rates around the world are glaring. In poor countries, half of the babies born at or below 32 weeks die due to a lack of appropriate care such as warmth, breastfeeding sup-port, and basic care for infections and breathing difficulties. In high-income countries, almost all of these babies survive [3]. The incidence of late preterm delivery and the contribution of multiple pregnancies appear to be growing. Increases in multiple births, obstetric intervention, and improved accuracy of measurement of gestational age have contributed to a rise in the incidence of late preterm delivery [4]. The approach to management of births in the late preterm period varies; it includes health education, health advice, and medical management such as glucocorticoids to decrease the incidence of neonatal respiratory distress syndrome (RDS) [5–8]. Previous findings endorsed imminent delivery if mothers were to go into labor during the late preterm period; however, recent literature has shown that expectant management of labor in the late preterm period is an acceptable alternative to care as compared to immediate delivery [5–7].


  1. 1.
    Miracle X, Di Renzo GC, Stark A, Fanaroff A, Carbonell-Estrany X, Saling E. Coordinators of world association of perinatal medicine (WAPM) prematurity group guidelines for the use of antenatal corticosteroids for fetal maturation. J Perinat Med. 2008;36:191–6.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Statistics Canada. Preterm live births in Canada, 2000 to 2013. Accessed 17 Oct 2017.
  3. 3.
    World Health organization (WHO). Preterm birth. 2017. Accessed 2 Feb 2018.
  4. 4.
    Souter V, Kauffman E, Marshall A, Katon J. Assessing the potential impact of extend-ing antenatal steroids to the late preterm period. Am J Obstet Gynecol. 2017;217(461):e1–7.Google Scholar
  5. 5.
    Lim J, Allen V, Scott H, Allen A. Late preterm delivery in women with preterm prelabour rupture of membranes. J Obstet Gynecol Can. 2010;32(6):555–60.CrossRefGoogle Scholar
  6. 6.
    Melamed N, Klinger G, Tenenbaum-Gavish K, Herscovici T, Linder N, Hod M, Yogev Y. Short-term neonatal outcome in low-risk, spontaneous, singleton, late preterm deliveries. Obstet Gynecol. 2009;114(2):253–60.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Quist-Nelson J, de Ruigh A, Seidler A, van der Ham D, Willekes C, Berghella V, et al. Immediate delivery compared with expectant management in late preterm prelabor rupture of membranes. Obstet Gynecol. 2018;0(0):1–11.Google Scholar
  8. 8.
    American Congress of Obstetricians and Gynecologists (ACOG). Practice bulletin: manage-ment of preterm labor. Obstet Gynecol. 2016;128:e155–64.CrossRefGoogle Scholar
  9. 9.
    Society of Obstetricians and Gynaecologists of Canada (SOGC). ALARM course manual, chapter 18: preterm labour and preterm birth. 23rd ed. Ottawa, ON: SOGC; 2017.Google Scholar
  10. 10.
    Lockwood CJ. Overview of preterm labor and delivery. UpToDate. Waltham, MA: UpToDate, Inc; 2012.Google Scholar
  11. 11.
    White DE, Fraser-Lee NJ, Tough S, Newburn-Cook CV. The content of prenatal care and its relationship to preterm birth in Alberta, Canada. Health Care Women Int. 2006;27(9):777–92.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Spong CY, Mercer BM, D’Alton M, Kilpatrick S, Blackwell S, Saade G. Timing of indicated late-preterm and early-term birth. National Institute of Child Health and Human Development. Obstet Gynecol. 2011;118(2 Pt 1):323–33. Scholar
  13. 13.
    Mitanchez D, Yzydorczyk C, Simeoni U. What neonatal complications should the pediatrician be aware of in case of maternal gestational diabetes? World J Diabetes. 2015;6(5):734–43. PMCID: PMC4458502CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    SOGC. Policy statement: maternal transport policy. J Obstet Gynaecol Can. 2005;27(10):956–8.CrossRefGoogle Scholar
  15. 15.
    Morisaki N, Togoobaatar G, Vogel JP, Souza JP, Rowland Hogue CJ, Jayaratne K, Ota E, Mori R. WHO multicountry survey on maternal and newborn health research network: risk factors for spontaneous and provider-initiated preterm delivery in high and low human development index countries: a secondary analysis of the World Health Organization multi-country survey on maternal and newborn health. BJOG. 2014;121(Suppl 1):101–9. Scholar
  16. 16.
    Booker W, Gyamfi-Bannerman C. Antenatal corticosteroids: who should we be treating? Clin Perinatol. 2018;45(2):181–98. Scholar
  17. 17.
    Wright N, Marinelli KA, The Academy of Breastfeeding Medicine. ABM protocol #1: guide-lines for glucose monitoring and treatment of hypoglycemia in term and late preterm neonates. Breastfeed Med. 2014;9(4):173–9.CrossRefGoogle Scholar
  18. 18.
    Byatt N, Hicks-Courant K, Davidson A, Levesque R, Mick E, Allison J, Moore-Simas TA. Depression and anxiety among high-risk obstetric inpatients. Gen Hosp Psychiatry J. 2014;35(2):112–6. Scholar
  19. 19.
    Brandon D, Tully K, Silva S, Malcolm W, Murtha A, Turner B, Holditch-Davis D. Emotional responses of mothers of late preterm and term infants. J Obstet Gynecol Neonatal Nurs. 2011;40:719–31. Scholar
  20. 20.
    Bright K, Becker G. Maternal emotional health before and after birth matters. In: Premji SS, editor. Late preterm infants. A guide for nurses, clinicians and allied health professionals. New York: Springer; 2018.Google Scholar
  21. 21.
    Gyamfi-Bannerman C, et al. Antenatal betamethasone for women at risk for late preterm deliv-ery. N Engl J Med. 2016;374(14):1311–20. Scholar
  22. 22.
    Society for Maternal-Fetal Medicine (SMFM). Implementation of the use of antenatal corti-costeroids in the late preterm birth period in women at risk for preterm delivery. Am J Obstet Gynecol. 2016;215(2):B14. Scholar
  23. 23.
    Wapner R, Gyamfi-Bannerman C, Thom E. What we have learned about antenatal corticoste-roid regimens. Semin Perinatol. 2016;40:291–7.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Smith GC, Rowitch D, Mol BW. The role of prenatal steroids at 34–36 weeks of gestation. Arch Dis Child Fetal Neonatal Ed. 2017;102:F284.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Chang YP. Evidence for the adverse effect of perinatal glucocorticoid use on the developing brain. Korean J Pediatr. 2014;57:101.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Canadian Premature Babies Foundation. Premature birth in Canada: an environmental scan–final report, 2014. Accessed 18 Oct 2017.Google Scholar
  27. 27.
    Nowik C, Davies G, Smith G. We should proceed with caution when it comes to antenatal corticosteroids after 34 weeks. J Obstet Gynecol Can. 2017;39(1):49–51.CrossRefGoogle Scholar
  28. 28.
    Kalra S, Kalra B, Gupta Y. Glycemic management after antenatal corticosteroid therapy. North Am J Med Sci. 2014;6(2):71–6. Scholar
  29. 29.
    Crowther C, Harding J. Antenatal glucocorticoids for late preterm birth? N Engl J Med. 2016;374(14):1376–7.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Adamkin DH. Committee on fetus and newborn. Clinical report-postnatal glucose homeostasis in late-preterm and term infants. Pediatrics. 2011;127(3):575–9.CrossRefGoogle Scholar
  31. 31.
    Pettit K, Tran S, Lee E, Caughey A. The association of antenatal corticosteroids with neonatal hypoglycemia and hyperbilirubinemia. J Matern Fetal Neonatal Med. 2014;27(7):1476–4954. Scholar
  32. 32.
    Garg M, Devaskar S. Glucose metabolism in the late preterm infant. Clin Perinatol. 2006;33:853–70.CrossRefGoogle Scholar
  33. 33.
    Saccone G, Berghella V. Antenatal corticosteroids for maturity of term or near term fetuses: sys-tematic review and meta-analysis of randomized controlled trials. Br Med J. 2016;355:i5044.CrossRefGoogle Scholar
  34. 34.
    Csont GL, Groth S, Hopkins P, Guillet R. An evidence-based approach to breastfeeding neo-nates at risk for hypoglycemia. J Obstet Gynecol Neonatal Nurs. 2014;3:71–81. Scholar
  35. 35.
    Wright J, Fowler Byers J, Norris A. Factors related to birth transition success of late preterm infants. Elsevier Newborn Infant Nurs Rev. 2012;12(2):97–105. Scholar
  36. 36.
    Adamkin PH. Postnatal glucose homeostasis in late preterm and term infants. Committee on fetus and newborn. Pediatrics. 2011;127:575–9.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Jennifer Marandola
    • 1
  • Gisela Becker
    • 2
  1. 1.volet Jeunesse/Santé-PubliqueCentre intégré universitaire de santé et de services sociaux de l’Ouest-de-l’île-de-MontréalMontréalCanada
  2. 2.Department of Health and Community ServicesGovernment of Newfoundland and LabradorSt. John’sCanada

Personalised recommendations