Fetomaternal outcomes beyond 40 weeks of gestation: a retrospective study

Background: Pregnancies extending beyond 40 weeks, categorized as late-term (40–41+6 weeks) or post-term (≥42 weeks), are associated with increased risks of adverse maternal and neonatal outcomes. This study aims to evaluate and compare fetomaternal outcomes in late-term and post-term pregnancies. Methods: This retrospective observational study was conducted at the department of obstetrics and gynecology, Chettinad health and research institute. Medical records of 300 women aged 18-45 years, who delivered after 40 weeks of gestation between January 1, 2023, and December 31, 2023, were analyzed. Exclusion criteria included teenage pregnancies, elderly gravida (>45 years), past caesarean sections, and breech/transverse presentations. Data on demographic characteristics, induction methods, maternal and neonatal outcomes, and complications were collected and statistically analyzed using SPSS version 25.0. Results: Out of 300 participants, 225 (75%) delivered at late-term, while 75 (25%) delivered post-term. Caesarean delivery rates were higher in post-term pregnancies (55%) compared to late-term (35%) (p<0.01). Maternal complications, including postpartum hemorrhage (PPH) (15%), perineal tears (10%), and uterine rupture (5%), were significantly more prevalent in post-term pregnancies (p<0.05). Neonatal complications were also higher in post-term deliveries, with increased rates of macrosomia (30% vs. 15%), NICU admissions (27% vs. 15%), and meconium-stained amniotic fluid (40% vs. 20%) (p<0.01). Stillbirths were exclusive to post-term pregnancies (7%). Conclusions: Post-term pregnancies are associated with significantly higher maternal and neonatal risks compared to late-term pregnancies. Timely induction of labor and enhanced surveillance in pregnancies beyond 40 weeks are crucial to minimizing complications. These findings support the implementation of evidence-based management strategies to improve fetomaternal outcomes in prolonged pregnancies.