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Updated: Aug 8, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal outcomes and long-term neurodevelopmental evaluations of hospitalized early term infants: prospective
E Yangin Ergon1, M Kivilcim2, R Colak1
1T.C. Ministry of Health Izmir Provincial Health Directorate H.S.U. Dr. Behçet Uz Children's Education and Research Hospital, Clinic of Neonatology, Izmir, Turkey.
Insights
Early term infants face more short-term health issues like feeding difficulties and higher hospitalization rates compared to full term infants. While neurodevelopmental outcomes were similar, early term babies showed lower cognitive and motor scores, suggesting potential long-term impacts.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Obstetrics
Background:
- Early term infants (born between 37 0/7 and 38 6/7 weeks) are often considered similar to full term infants.
- However, subtle physiological immaturities may lead to short-term and long-term complications.
Purpose of the Study:
- To compare short-term health outcomes and long-term neurodevelopmental evaluations between early term and term infants.
- To identify potential risks associated with early term birth.
Main Methods:
- A prospective case-control study involving 109 early term infants (born via elective cesarean) and 109 term infants.
- Data collected included nutritional status, reasons for hospitalization, and neurodevelopmental assessments at 18-24 months.
Main Results:
- Early term infants experienced delayed breastfeeding initiation, increased breastfeeding difficulties, and higher rates of formula supplementation.
- Pathological weight loss, hyperbilirubinemia requiring phototherapy, and feeding difficulties were significantly more common in the early term group.
- No significant difference in overall neurodevelopmental delay was observed, but early term infants had lower Mental Development Index (MDI) and Psychomotor Development Index (PDI) scores.
Conclusions:
- Early term infants, despite appearing similar to term infants, exhibit physiological immaturity with evident short- and long-term negative consequences.
- Non-medically indicated, elective early term births should be avoided to mitigate these risks.
Backgrounds:
It was intended to compare early term babies to term babies by reviewing short-term issues and long-term neurodevelopmental evaluations.
Methods:
It was planned as a prospective case-control study. Of the 4263 infants admitted to the neonatal intensive care unit, 109 infants born at early term by elective cesarean section and hospitalized within the first 10 postnatal days were included in the study. As the control group, 109 babies born at term were enrolled. Nutrition status of infants, reasons for hospitalization in the first postnatal week were recorded. When the babies were 18-24 months old, an appointment was made for neurodevelopmental evaluation.
Results:
In the early term group, the time of breastfeeding was later than the control group, with a statistically significant difference. Similarly, breastfeeding difficulty, need for formula in the first week postpartum and hospitalization were found to be significantly higher in the early term group. Considering the short-term results; pathological weight loss, hyperbilirubinemia requiring phototherapy and feeding difficulties were statistically significantly higher in the early term group. Neurodevelopmental delay did not statistically differ across the groups, but the early term group's MDI and PDI scores were found to be statistically lower than those of the term group.
Conclusion:
Early term infants are thought to be like term infants in many ways. Although these babies are similar to term babies, they are still physiologically immature. The short and long-term negative consequences of early term birth are obvious, non-medical elective early term births should be prevented.
