Following the deaths of several babies, Swedish researchers have prematurely discontinued an initiation study on long pregnancies. Five babies, whose mothers were born after the 42nd week of pregnancy, were born dead, and one died immediately after delivery, according to the Swepis study published in the journal British Medical Journal.
In Germany, the guideline of the German Society for Gynecology and Obstetrics (DGGG) recommends that a child should be born at the end of the 41st week of pregnancy, but at the latest a few days later. An excess of 42 weeks, which is also referred to as a transfer, should - as far as possible - be avoided as far as possible. Among other reasons, the guideline authors state the increased risk of death of the child. The guideline, which expired this year, is currently being revised. The World Health Organization also recommends induction of childbirth when it is certain that 41 weeks of pregnancy have been reached.
In Sweden, there is another practice: as in the UK, the birth process is usually initiated in long pregnancies until the 42nd week of pregnancy. "In most clinics in Sweden, this is routinely Week 42," said Research Director Ulla-Britt Wennerholm from the University of Gothenburg.
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In the study, the researchers wanted to find out if there is a difference in perinatal and maternal outcomes when labor is initiated after the 41st or 42nd week of pregnancy. From 2016 to 2018, a total of 2,760 healthy pregnant women at 14 maternity wards in Sweden, whose pregnancy had already lasted about 41 weeks, were divided into two groups: women in the first group were given birth within the next 24 hours, and in the other with or shortly after the completion of the 42nd week.
Researchers recommend Swedish clinics birth induction after 41 weeks
In the first group there were no deaths, in the second group, however, died six babies. Because of the deaths, the study was terminated for ethical reasons, said Wennerholm. Overall, the results of the research should be interpreted with caution, since there were no significant differences between the two groups for other parameters, the researchers write in their study.
However, due to the imminent complications, Swedish clinics recommend that expectant mothers be offered discharge at the latest after the end of the 41st week of pregnancy instead of 42 weeks. This should reduce the risk of possible stillbirths. They estimate that the initiation after 41 weeks could prevent one death per 230 pregnancies. According to studies in the United States and the United Kingdom, about four to five percent of pregnant women transmit their child.
It was originally planned to examine 10,000 pregnant women, said Wennerholm. However, at the end of 2018, following indications from an independent inspection authority of the deaths, they decided to abandon the study.
The risk of a baby dying before, during or shortly after birth, according to scientists in Sweden, is generally very low. Nevertheless, the danger increases from the 40th Week of pregnancy increasingly. Wennerholm expected the publication to launch a larger debate on what to do.
