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Predictors of adverse short-term outcomes in late preterm infants
Nina Mekic1, Amela Selimovic2, Almira Cosickic2
1Pediatric Department, Health and Educational Medical Center Tuzla, Tuzla, Bosnia and Herzegovina. ninabrcic88@gmail.com.
Insights
Late preterm infants (34-36 weeks) face significant risks, with respiratory issues being most common. Lower gestational age and male sex increase the likelihood of complications in these newborns.
Area of Science:
- Neonatal Medicine
- Perinatology
- Public Health
Background:
- Late preterm infants (LPIs), born between 34 and 36 weeks gestation, constitute a significant portion (74%) of premature births.
- Preterm birth remains a leading global cause of infant mortality and morbidity.
- Understanding LPI outcomes is crucial for neonatal care and public health strategies.
Purpose of the Study:
- To analyze short-term morbidity and mortality in late preterm infants.
- To identify predictors of adverse outcomes in this vulnerable population.
- To inform clinical decision-making and improve neonatal care protocols.
Main Methods:
- Retrospective study of 154 LPIs admitted to the Neonatal Intensive Care Unit (NICU) from 2020-2022.
- Data collected included infant characteristics (gestational age, birth weight, Apgar score) and maternal factors.
- Logistic regression analysis was employed to identify risk factors for neonatal morbidity.
Main Results:
- Respiratory complications were the most frequent adverse outcome, followed by CNS morbidity, infections, and jaundice.
- Increased gestational age (34-36 weeks) correlated with decreased complication rates.
- Lower birth weight and male sex were significant predictors of respiratory morbidity.
Conclusions:
- Younger gestational age in LPIs is linked to higher short-term complication risks.
- Identifying risk factors like birth weight and sex is vital for targeted interventions.
- Further research into LPI epidemiology can optimize clinical practices and reduce neonatal morbidity.
Background:
Infants born between 34 weeks and 36 weeks and 6 days of gestation are defined as late preterm infants (LPIs), and they account for approximately 74% of all premature births. Preterm birth (PB) remains the leading cause of infant mortality and morbidity worldwide.
Aim:
To analyse short-term morbidity and mortality and identify predictors of adverse outcomes in late preterm infants.
Patients And Methods:
In this retrospective study, we evaluated adverse short-term outcomes of LPIs admitted to the Intensive Care Unit (ICU), Clinic for Children's Diseases, University Clinical Center Tuzla, between 01.01.2020 and 31.12.2022. The analysed data included sex, gestational age, parity, birth weight, Apgar score (i.e., assessment of vitality at birth in the first and fifth minutes after birth), and length of hospitalization in NICU, as well as short-term outcome data. Maternal risk factors we observed were: age of mother, parity, maternal morbidity during pregnancy, complications and treatment during pregnancy. LPIs with major anatomic malformations were excluded from the study. Logistic regression analysis was used to identify risk factors for neonatal morbidity among LPIs.
Results:
We analysed data from 154 late preterm newborns, most of whom were male (60%), delivered by caesarean Sect. (68.2%) and from nulliparous mothers (63.6%). Respiratory complications were the most common outcome among all subgroups, followed by CNS morbidity, infections and jaundice requiring phototherapy. The rate of almost all of the complications in the late-preterm group decreased as gestational age increased from 34 to 36 weeks. Birth weight (OR: 1,2; 95% CI: 0,9 - 2,3; p = 0,0313) and male sex (OR: 2,5; 95% CI: 1,1-5,4; p = 0,0204) were significantly and independently associated with an increased risk for respiratory morbidity, and gestational weeks and male sex were associated with infectious morbidity. None of the risk factors analysed herein were predictors of CNS morbidity in LPIs.
Conclusion:
A younger gestational age at birth is associated with a greater risk of short-term complications among LPIs, thus highlighting the need for increased knowledge about the epidemiology of these late preterm births. Understanding the risks of late preterm birth is critical to optimizing clinical decision-making, enhancing the cost-effectiveness of endeavours to delay delivery during the late preterm period, and reducing neonatal morbidity.
