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Published on: November 20, 2015
Late prematurity: a systematic review
Luís Carlos Machado Júnior1, Renato Passini Júnior1, Izilda Rodrigues Machado Rosa2
1Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Insights
Late preterm births, occurring between 34 and 36 weeks, are increasing and linked to higher mortality and long-term health issues. Strategies to improve outcomes for these infants are being evaluated.
Area of Science:
- Perinatal Medicine
- Neonatology
- Public Health
Background:
- Late preterm birth (34 to 36 weeks and 6 days gestation) represents a growing proportion of preterm births.
- This demographic is associated with increased risks compared to full-term infants.
Purpose of the Study:
- To conduct a comprehensive literature review on late preterm births.
- To examine various aspects including incidence, outcomes, and potential interventions.
Main Methods:
- Systematic search of MEDLINE, LILACS, and Cochrane Library databases.
- Inclusion of references from retrieved articles without time limitations.
Main Results:
- Late preterm births show a recent increase and constitute the majority of preterm births.
- Strong associations found with neonatal mortality, childhood mortality, and young adult mortality.
- Linked to numerous neonatal complications and long-term sequelae such as cerebral palsy, asthma, and diabetes.
Conclusions:
- Late preterm infants face significantly higher mortality and morbidity, along with long-term developmental challenges.
- Emerging strategies focus on antenatal corticosteroids and modified delivery/neonatal care guidelines.
- Further research is essential to validate and refine these interventions for improved neonatal outcomes.
Objective:
this study aimed to review the literature regarding late preterm births (34 weeks to 36 weeks and 6 days of gestation) in its several aspects.
Sources:
the MEDLINE, LILACS, and Cochrane Library databases were searched, and the references of the articles retrieved were also used, with no limit of time.
Data Synthesis:
numerous studies showed a recent increase in late preterm births. In all series, late preterm comprised the majority of preterm births. Studies including millions of births showed a strong association between late preterm birth and neonatal mortality. A higher mortality in childhood and among young adults was also observed. Many studies found an association with several neonatal complications, and also with long-term disorders and sequelae: breastfeeding problems, cerebral palsy, asthma in childhood, poor school performance, schizophrenia, and young adult diabetes. Some authors propose strategies to reduce late preterm birth, or to improve neonatal outcome: use of antenatal corticosteroids, changes in some of the guidelines for early delivery in high-risk pregnancies, and changes in neonatal care for this group.
Conclusions:
numerous studies show greater mortality and morbidity in late preterm infants compared with term infants, in addition to long-term disorders. More recent studies evaluated strategies to improve the outcomes of these neonates. Further studies on these strategies are needed.
