Late preterm and early term birth: Challenges and dilemmas in clinical practice

Area of Science:

• Neonatal research
• Perinatal medicine
• Developmental pediatrics

Background:

• Historically, neonatal research prioritized extremely preterm infants (before 32 weeks gestation).
• Emerging evidence highlights a spectrum of risk across all gestational ages, including late preterm and early term births.
• Adverse outcomes in late preterm and early term infants, though potentially less severe individually, affect large numbers and impact multiple life domains.

Purpose of the Study:

• To address the inadequate understanding of factors influencing outcomes for late preterm and early term infants.
• To emphasize the need for further research to guide clinical practice.
• To optimize both short- and long-term outcomes for this population.

Main Methods:

• This study is a review and synthesis of existing knowledge.
• It identifies gaps in the evidence base regarding late preterm and early term birth outcomes.
• It highlights the challenges in managing pregnancies and infants affected by these birth timings.

Main Results:

• A gradient of risk exists across the entire gestational age spectrum.
• Late preterm and early term infants represent a significant population with diverse health, developmental, and educational challenges.
• Current knowledge regarding the mechanisms and influencing factors is insufficient.

Conclusions:

• Further research is crucial to develop evidence-based guidelines for managing late preterm and early term births.
• Optimizing care for these infants is essential for improving lifelong health and development.
• The focus of neonatal research needs to broaden beyond extreme prematurity.