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Published on: December 31, 2015
[Late preterm infants in Spain: Experience of the 34-36 Neonatal Group]
Mercedes García-Reymundo1, Xavier Demestre2, María José Calvo3
1Grupo SEN34-36/ACUNA, Sociedad Española de Neonatología, España; Unidad de Neonatología, Hospital Mérida, Mérida, Badajoz, España.
Insights
Late preterm infants face higher mortality and morbidity. This study highlights risks associated with multiple births, maternal conditions, and interventions like C-sections in Spain.
Area of Science:
- Neonatalogy
- Public Health
- Epidemiology
Background:
- Late preterm (LP) infants (34-36 weeks gestation) represent a significant, understudied preterm population.
- Understanding their current health status in Spain is crucial for improving care and reducing adverse outcomes.
Purpose of the Study:
- To analyze the clinical-epidemiological characteristics of late preterm infants in Spain.
- To identify factors contributing to their morbidity and mortality.
Main Methods:
- Prospective collection of clinical-epidemiological data from 9,121 late preterm infants across 34 Spanish hospitals (2011-2016).
- Comparison with data from term infants.
Main Results:
- Mortality rate was 2.8%. High rates of multiple pregnancies (27.7%), maternal disease (47.1%), and pathological gestations (41.4%) were observed.
- Nearly half (47.9%) were born via C-section, with 18.8% of unjustified origin. Significant admissions to neonatology (58.6%) and NICU (15.2%) occurred.
- Common diagnoses included jaundice (43.5%), hypoglycemia (30%), and respiratory disorders (28.7%).
Conclusions:
- Late preterm infants experience elevated neonatal mortality and morbidity.
- Incidence is linked to multiparity, advanced maternal age, labor inductions, and unjustified C-sections.
Introduction:
Late preterm (LP) infants (34 -36 weeks of gestation) are the largest group of preterm infants and also the least studied so far. In order to improve their care and reduce the impact of their increased morbidity and mortality, it is essential to know the current situation in Spain.
Population And Method:
Clinical-epidemiological variables of the LP population of 34 participating hospitals were prospectively collected from 1 April 2011 to 31 March 2016, and were then compared with the Minimum Perinatal Data Set for term births in the database.
Results:
Of the 9,121 LP studied, 21.7% of 34, 30.8% of 35, and 47.5% of 36 weeks of gestation. The mortality rate was 2.8%. More than one-quarter (27.7%) were multiple pregnancies. Maternal disease were identified in 47.1% and 41.4% were pathological gestation. Just under half (47.9%) were by Caesarean section and 18.8% were of unknown origin or unjustified. No known cause of prematurity was found in 29%, and 3.1% were recognized as unjustified?caesarean?. Just under half (47%) of the LP were breastfed, and 58.6% required admission to neonatology, with 15.2% to Neonatal Intensive Care Unit. Coded diagnoses were recorded in 46.2%, with the most frequent being jaundice, 43.5%, hypoglycaemia, 30%, and respiratory disorders with 28.7%.
Conclusions:
The large sample of LP studied helps us to highlight the higher neonatal mortality and morbidity that this population suffers and the unavoidable relationship of its incidence with multiparity, maternal aging, and the still numerous inductions of labour and unjustified elective caesareans.
