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Published on: November 20, 2015
Short- and Long-Term Consequences of Late-Preterm and Early-Term Birth
Muhammad Arham1, Katarzyna Wróblewska-Seniuk2
1Department of Pediatrics, Rawalpindi Medical University, Rawalpindi 46000, Pakistan.
Insights
Late-preterm and early-term births pose higher risks for newborns, including respiratory issues and developmental delays. These risks extend into adulthood, impacting long-term health and mortality rates.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Public Health
Background:
- Late-preterm (34-36 weeks) and early-term (37-38 weeks) infants were previously considered low-risk, similar to full-term infants.
- Emerging evidence indicates these infants possess relative physiologic and developmental immaturity.
- This immaturity contributes to increased risks for neonatal morbidities and long-term adverse outcomes.
Purpose of the Study:
- To review current knowledge on the risks associated with late-preterm and early-term births.
- To identify gaps in the existing literature regarding these risks.
- To highlight future research directions for improving outcomes.
Main Methods:
- Literature review of recent evidence on neonatal and long-term outcomes.
- Synthesis of data on morbidities, neurodevelopmental issues, and mortality.
- Identification of knowledge gaps and areas for future research.
Main Results:
- Late-preterm and early-term infants face significantly higher risks of neonatal morbidities (e.g., respiratory distress, jaundice, hypoglycemia).
- These infants exhibit increased susceptibility to neurodevelopmental delays, behavioral problems, and chronic adult diseases.
- Elevated risks for infant and adult mortality are observed in these populations.
Conclusions:
- Late-preterm and early-term births are associated with substantial short- and long-term health risks.
- Current understanding of these risks is evolving, necessitating further research.
- Optimizing care and interventions for these infants is crucial for improving lifelong health trajectories.
Abstract:
Late-preterm (340/7-366/7 weeks) and early-term (370/7-386/7 weeks) newborns were, up until recently, erroneously categorized as low-risk and were conflated with full-term (390/7-406/7 weeks) deliveries. However, emerging evidence refuted this notion and demonstrated that late-preterm and, to a lesser extent, early-term newborns have a significantly higher risk of experiencing various neonatal morbidities, including respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, jaundice, hypoglycemia, and breastfeeding difficulties, compared to their full-term counterparts-reflecting their relative physiologic and developmental immaturity. Recent evidence also unravels the lingering adverse effects of late-preterm and early-term delivery up until mid-adulthood, with the increased susceptibility of these newborns to neurodevelopmental delays, behavioral and neuropsychiatric problems, and adult chronic diseases. Moreover, apart from increased neonatal and infant mortality rates, these newborns continue to encounter a heightened risk of mortality even up to mid-adulthood. As the full spectrum of the complications these newborns face is gradually being unveiled, this review presents and discusses the current knowledge base, identifies gaps in the literature, and highlights future research implications.
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