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Published on: November 20, 2015
Early neonatal morbidities in late preterm infants
Ashish Jaiswal1, Srinivas Murki, Pramod Gaddam
1Fernandez Hospital, Hyderabad, Andhra Pradesh 503 001, India.
Insights
Late preterm infants face significantly higher risks for neonatal conditions like respiratory issues, jaundice, and sepsis compared to term infants. These risks increase with earlier gestational ages, highlighting the vulnerability of this population.
Area of Science:
- Neonatal Medicine
- Perinatal Health
- Pediatric Outcomes
Background:
- Late preterm infants (34-36 weeks gestation) represent a significant proportion of births.
- These infants are often perceived as similar to term infants, potentially leading to underestimation of their health risks.
- Early neonatal morbidity is a critical concern in the first week of life.
Purpose of the Study:
- To compare the incidence and types of early neonatal morbidity between late preterm infants and term infants.
- To identify specific health risks associated with late preterm birth within the first seven days of life.
Main Methods:
- A prospective cohort study design was employed.
- Inclusion criteria encompassed all liveborn late preterm infants (34 0/7 to 36 6/7 weeks) and term infants (37 0/7 to 41 6/7 weeks).
- Neonatal morbidity was defined as the presence of specific medical conditions requiring inpatient hospital observation, admission, or readmission within the first seven days post-delivery.
Main Results:
- The study included 363 late preterm infants and 2707 term infants.
- Late preterm infants exhibited a substantially higher rate of overall neonatal morbidity (70.8%) compared to term infants (29.1%).
- Significantly elevated risks were observed in late preterm infants for respiratory morbidity (OR: 7.5), need for ventilation (OR: 4.2), jaundice (OR: 3.4), hypoglycemia (OR: 4.5), and probable sepsis (OR: 3.2). Morbidity incidence increased progressively with decreasing gestational age from 40 weeks.
Conclusions:
- Late preterm infants are at a considerably higher risk for multiple early neonatal morbidities, including respiratory distress, need for respiratory support, jaundice, hypoglycemia, and sepsis, when compared to term infants.
- Gestational ages below 39 weeks were associated with significantly increased morbidity risk, with 40 weeks serving as the reference.
- These findings underscore the need for vigilant monitoring and tailored care strategies for late preterm infants.
Objectives:
To compare early neonatal morbidity (within first 7 days of life) in late preterm infants with term infants.
Study Design:
Prospective cohort study.
Subjects:
All live inborn late preterm infants (34 0/7 to 36 6/7 weeks) and term infants (37 0/7 to 41 6/7 weeks).
Outcome:
Any of the predefined medical conditions listed in the study, resulting in post- delivery inpatient hospital observation, admission, or readmission in first 7 days of life.
Results:
363 late preterm infants and 2707 term infants were included in study. Two hundred fifty seven (70.8 %) of late preterm and 788 (29.1%) of term infants had at least one of the predefined neonatal conditions. Late preterm infants were at significantly higher risk for overall morbidity due to any cause (P<0.001; adjusted Odds Ratio (OR): 5.5; 95% CI: 4.2-7.1), respiratory morbidity (P<0.001; adjusted OR: 7.5; 95% CI: 4.2-12.3), any ventilation (non invasive or invasive) (P=0.001; adjusted OR: 4.2; 95% CI: 2-8.9), jaundice (P<0.001; adjusted OR: 3.4; 95% CI: 2.7-4.4), hypoglycemia (P<0.001; adjusted OR: 4.5; 95% CI: 2.6-7.7), and probable sepsis (P<0.001; adjusted OR: 3.2; 95% CI: 1.6-6.5). The incidence of morbidities increased from 23% at 40 weeks to 30%, 39.7%, 67.5%, 89% and 87.9% at 38, 37, 36, 35 and 34 weeks, respectively (P<0.001).
Conclusion:
Compared with term infants, late preterm infants are at high risk for respiratory morbidity, need of ventilation (non invasive or invasive), jaundice, hypoglycemia, sepsis, and probable sepsis. All gestations except 39 weeks were at significantly higher risk for morbidity with 40 weeks as reference term.
