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Short-Term Neonatal Outcomes Following Early-Term vs. Full-Term and Late-Preterm Births: Insights from a
Nadav Kadosh1, Ron Zeitouni2, Roni Shlesinger Schwartz3
1Department of Pediatrics, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel.
Insights
Early-term (ET) infants show higher morbidity than full-term (FT) infants, including longer hospital stays and increased NICU admissions. These findings suggest avoiding elective delivery before 39 weeks gestation unless medically necessary.
Area of Science:
- Neonatal Medicine
- Perinatal Health
- Developmental Pediatrics
Background:
- Gestation is a developmental continuum, with distinct subgroups like early-term (ET) and full-term (FT) infants exhibiting varied clinical outcomes.
- Subtle differences in gestational age can lead to significant variations in infant morbidity and health.
- Understanding these nuances is crucial for optimizing neonatal care and delivery timing.
Purpose of the Study:
- To compare early neonatal outcomes among late-preterm (LP), early-term (ET), and full-term (FT) infants.
- To identify specific risks and clinical differences associated with each gestational age subgroup.
- To inform clinical practice regarding delivery timing and neonatal management.
Main Methods:
- Retrospective observational study of infants born between 34 and 41 weeks gestation.
- Infants categorized into late-preterm (34-36 weeks), early-term (37-38 weeks), and full-term (39-41 weeks).
- Primary outcome: length of stay; Secondary outcomes: NICU admissions, respiratory support, feeding, weight loss, and re-hospitalizations.
Main Results:
- Early-term infants experienced intermediate outcomes between late-preterm and full-term groups.
- Early-term infants had longer lengths of stay and required more respiratory support than full-term infants.
- Late-preterm infants had higher NICU admission rates, while early-term infants showed greater weight loss and higher readmission rates compared to full-term infants.
Conclusions:
- Early-term infants, though more stable than late-preterm infants, exhibit increased short-term morbidity compared to full-term neonates.
- Findings support delaying elective delivery until at least 39 weeks gestation unless clinically indicated.
- Optimizing delivery timing can potentially reduce neonatal complications and improve long-term health outcomes.
Background:
Conceptualizing gestation as a developmental continuum highlights that even among term infants, distinct subgroups-such as early-term and full-term infants-may exhibit meaningful differences in morbidity and clinical outcomes.
Objective:
To compare early neonatal outcomes among late-preterm (LP), early-term (ET), and full-term (FT) infants.
Methods:
A retrospective observational study analyzed data of infants born between 34+0 and 41+6 weeks at Hadassah Medical Centers in 2023. Infants were stratified by gestational age. Late-preterm was defined as birth between 34 - 36 + 6 weeks of gestation, early-term 37 - 38 + 6 weeks, and term birth between 39 - 41 + 6 weeks. Primary outcome was length of stay (LOS), secondary outcomes included NICU admissions, respiratory support, feeding type, weight loss, and re-hospitalizations within the first year following discharge.
Results:
ET infants had intermediate outcomes between LP and FT groups. LOS and respiratory support needs were higher in ET than FT infants. NICU admissions were significantly more frequent in LP infants; ET infants exhibited higher weight loss and more frequent elective cesarean deliveries compared to FT infants. Readmission rates were higher in ET compared to FT infants.
Conclusions:
ET infants, while more stable than LP infants, experienced increased short-term morbidity compared to FT neonates. These findings support minimizing elective delivery before 39 weeks unless clinically indicated.
