Introduction
Research has shown that early elective delivery without medical or obstetrical indication is linked to neonatal morbidities with no benefit to the mother or infant.1 The American Congress of Obstetricians and Gynecologists (ACOG) publications, (1979, 1999, 2009) have consistently advised against non-medically indicated elective deliveries prior to 39 weeks gestation.2 Recent studies highlight concerns that late preterm and possibly early term deliveries may increase babies’ risk of brain injury and long-term neurodevelopmental abnormalities.1,3 Approximately 50% of cortical volume growth occurs between 34 and 40 weeks. At 37 weeks, the brain weighs only 80% of the weight at 40 weeks and gray matter volume increases at a rate of 1.4% per week between 36 and 40 weeks.1 Similarly, there is rapid growth of the cerebellum with approximately 25% of its volume developing after the late preterm period.1 MRI evaluation in preterm infants has shown an impairment of the cerebellar growth compared to term infants. 3
[1] March of Dimes @ http://www.marchofdimes.com/southcarolina/news_modworththewaitnationalagenda12.html
[2] The American Congress of Obstetricians and Gynecologists @ http://www.acog.org/
[3] Neonatal MRI to Predict Neurodevelopmental Outcomes in Prhttp://www.acog.org/http://www.acog.org/eterm Infants by Woodward et al, August 17, 2006 in The England Journal of Medicine @ http://www.nejm.org/doi/full/10.1056/NEJMoa053792
