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Macro preemies: no thresholds for risks or concerns
Laura Fletcher1, Ruth Milanaik
1Developmental & Behavioral Pediatrics, Steven & Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York, USA.
Insights
Moderate to late preterm infants (32-36 weeks gestation) face significant medical and developmental risks. Early and comprehensive follow-up care is crucial for these infants, often called "macro preemies," to mitigate potential health issues.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
Background:
- Moderate to late preterm infants (32-36 weeks gestation) are at increased risk for medical and developmental issues.
- These infants, sometimes termed 'macro preemies,' experience morbidities due to immature organ systems.
Purpose of the Study:
- To review the literature on medical and developmental risks for moderate to late preterm infants.
- To highlight the pediatrician's role in managing these infants during inpatient and outpatient care.
Main Methods:
- Literature review of medical and developmental risks.
- Focus on care strategies for preterm infants.
Main Results:
- Infants born at 32-36 weeks gestation show higher risks for medical complications (e.g., temperature instability, respiratory issues, feeding difficulties, jaundice, hypoglycemia, infections).
- These infants also exhibit increased incidence of developmental deficits in motor skills, speech, communication, learning, and behavior compared to full-term infants.
- Careful attention from birth is necessary to address potential medical and developmental delays.
Conclusions:
- Physicians must recognize the heightened medical and developmental risks in preterm infants.
- Comprehensive medical and neurodevelopmental follow-up care is essential for all infants born before term.
Purpose Of Review:
To provide an overview of the literature regarding medical and developmental risks for moderate to late preterm infants (32-36 weeks gestation), with particular attention to the pediatrician's role in care during both inpatient and outpatient periods.
Recent Findings:
Although the risks of medical issues and developmental delays decrease with increasing gestational age, research suggests that infants born after 32 weeks' gestation often exhibit significant morbidities associated with prematurity. These infants, often referred to as 'macro preemies', have been found to be at a greater risk for medical complications secondary to immature organ systems including impairments in temperature regulation, respiratory functioning, feeding coordination, bilirubin excretion, glucose control, and infection susceptibility. Recent studies of macro preemies also suggest a higher incidence of significant deficits noted in gross and fine motor skills, speech and communication, and learning and behavior compared to their full-term counterparts. Without careful attention from birth, macro preemie infants could be susceptible to both medical issues and developmental delays.
Summary:
Physicians should be aware of the research regarding increased medical and developmental risks for all infants born before term in order to provide their patients with comprehensive medical and neurodevelopmental follow-up care.
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