Late preterm births: a retrospective analysis of the morbidity risk stratified for gestational age

Abstract

PurposeLate-preterm births are considered functionally mature but, several line of evidences suggest that, compared with term neonates, they have a higher risk of complications. The aim of this study was to compare the incidence of maior clinical complications of late preterm infants born in our division, compared to those born at term.MethodsWe retrospectively analysed late preterm deliveries occurred in a twenty-months period. Late preterms were divided in 3 sub-groups according to gestational age at delivery: 34 0/6 , 35 0/6 , 36 0/6 weeks of gestation. The incidence of maior clinical complications was evaluated. Statistical analysis was performed by using the Z- test.ResultsAmong term deliveries 17.24% were admitted to the neonatal intensive care unit and 69.01% presented one major adverse outcome: 25.35% jaundice, 25.35% hypoglycemia , 11.26% RDS , 4.22% intraventricular hemorrhage (IVH), 4,22% anemia. The incidence of IVH was significantly higher only at 340/6 weeks of gestation compared to term infants. The incidence of anemia and RDS was significantly higher at 34 0/6 and 35 0/6 weeks of gestation, but it was not significantly different at 36 weeks of gestation, compared to full-term infants. Finally, the incidence of hypoglycemia and jaundice results significantly higher in all the 3 sub groups of late preterms, compared to full term infants.ConclusionsResults demostrated an increased risk of morbidity in the late preterm period. Results also showed that the gestational age at delivery of late preterms can influence the risk of adverse neonatal outcomes.

Integrative Review of Interventions to Promote Breastfeeding in the Late Preterm Infant

“…Physical immaturities in late preterm infants can lead to severe respiratory distress, hypoglycemia, and hypothermia that require escalation of care and separation of the infant from the mother and delay initiation of breastfeeding (Boyle et al, 2015; Marrocchella et al, 2014). Additionally, in late preterm infants, neuronal immaturity affects oro-motor tone that causes poor suck-swallow coordination, decreased intraoral pressure, and an inadequate suck (AWHONN, 2010; Polin & Fox, 2010).…”

Outcome of Late Preterm Newborns

“…Similarly Darcy (2009) and Premji et al, (2012) found that hyperbilirubinemia is the most common reason for admission in the LPI population as the peak serum bilirubin is often not seen until 5 to 7 days of life. [21,22] In our study hypoglycemia was higher in LPT infants than full term ones with, and it decreased with increase of GA. Marrocchella et al, (2014) found that the incidence of hypoglycemia and jaundice results significantly higher in all LPs, compared to FT infants and also found that hypoglycemia decreased with increase in GA.23This findings is explained by the fact that limited glycogen stores and rapid depletion of glucose stores from the metabolic demands of the newborn transition period can result in hypoglycemia, cold stress, poor suck/swallow ability and respiratory complications contribute to the risk of developing hypoglycemia. [21,24] In this study convulsion was significantly high in LPT infants compared to FT one, observed more in 34th and 35th WKs GA.…”

Das späte Frühgeborene – unterschätzte Morbidität

“…Hypoglykämien treten im Vergleich zu reifen Neugeboren deutlich häufiger auf und werden mit steigendem Gestationsalter seltener [35,38,39]. Die geringeren Energiereserven (Glykogendepot) und deren schlechtere Verfügbarkeit sind für die Mehrzahl der Hypoglykämien verantwortlich.…”