Respiratory morbidity in late preterm infants

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology
• Obstetrics

Background:

• Late preterm delivery (34-36 weeks) accounts for 74% of preterm births.
• These infants exhibit increased respiratory pathology, including respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN), compared to term infants.
• Ventilator support is also more common in late preterm infants.

Purpose of the Study:

• To evaluate respiratory morbidity and mortality in late preterm infants.
• To identify risk factors associated with RDS and TTN in this population.

Main Methods:

• Retrospective study of 498 newborns born between 34+0 and 36+6 weeks gestational age.
• Exclusion criteria included major malformations, chromosomopathies, hydrops fetalis, and congenital TORCH infections.
• Data analysis focused on respiratory outcomes and associated maternal and neonatal factors.

Main Results:

• 44 infants (8.83%) experienced RDS or TTN.
• Respiratory morbidity linked to lower gestational age, male gender, cesarean section, peripartum antibiotics, maternal overweight, and nulliparity.
• Newborns with RDS required more resuscitation, intubation, oxygen, ventilation, parenteral nutrition, and had longer NICU stays than those with TTN.
• Cesarean section and resuscitation with endotracheal tube were independent risk factors for respiratory morbidity.

Conclusions:

• Late preterm infants, especially those born after 35 weeks without antenatal corticosteroids, remain at high risk for adverse respiratory outcomes.
• Cesarean section is an independent risk factor for respiratory morbidity, necessitating efforts to reduce its rate.
• Evidence supports extending management guidelines into the late preterm period.