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Perinatal outcomes associated with preterm birth at 33 to 36 weeks' gestation: a population-based cohort study

Minesh Khashu1, Manjith Narayanan, Seema Bhargava

  • 1Neonatal Service, Poole Hospital NHS Foundation Trust, Dorset, England.

Pediatrics
|January 2, 2009
PubMed

Insights

Late-preterm infants (33-36 weeks) face higher mortality and morbidity risks compared to full-term infants. This study highlights increased needs for respiratory support, infection management, and longer hospital stays for this vulnerable population.

Area of Science:

  • Neonatal Medicine
  • Perinatal Epidemiology
  • Public Health

Background:

  • Advancements in neonatal care have shifted focus from late-preterm infants, treating them as
  • near-term
  • and
  • near-normal.
  • Emerging evidence suggests increased risks for this group compared to term infants.
  • Limited population-based data exist on current mortality and morbidity for late-preterm infants.

Purpose of the Study:

  • To compare mortality and morbidity rates between late-preterm infants (33-36 weeks gestation) and term infants (37-40 weeks gestation).
  • To identify maternal factors associated with late-preterm births.
  • To inform care practices and resource allocation for late-preterm infants.

Main Methods:

  • Population-based cohort study using the British Columbia Perinatal Database Registry.
  • Analysis of singleton births between 33 and 40 weeks gestation (April 1999 - March 2002).
  • Comparison of mortality, morbidity, and maternal factors between late-preterm (n=6381) and term (n=88,867) groups.

Main Results:

  • Late-preterm infants exhibited significantly higher stillbirth rates and perinatal, neonatal, and infant mortality.
  • Increased incidence of respiratory morbidity, infection, and need for resuscitation at birth in the late-preterm group.
  • Late-preterm infants experienced longer hospital stays; associated maternal factors included chorioamnionitis, hypertension, diabetes, and teenage pregnancy.

Conclusions:

  • Findings support recent literature on increased neonatal mortality and morbidity in late-preterm infants.
  • A review of care for late-preterm infants is warranted at all healthcare levels.
  • Reorganization of services and increased resource allocation may be necessary to optimize care for this population.
Abstract

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