Rooming-in organization to prevent neonatal mortality and morbidity in late preterm infants

ObjectiveAfter a decade of increase, the preterm birth (PTB) rate has declined in the USA since 2006, with the largest decline at late preterm (34–36 weeks). We described concomitant changes in gestational age-specific rates of neonatal mortality and morbidity following spontaneous and clinician-initiated PTB among singleton infants.Design, setting and participantsThis retrospective population-based study included 754 763 singleton births in Washington State, USA, 2004–2013, using data from birth certificates and hospitalisation records. PTB subtypes included preterm premature rupture of membranes (PPROM), spontaneous onset of labour and clinician-initiated delivery.Outcome measuresThe primary outcomes were neonatal mortality and a composite outcome including death or severe neonatal morbidity. Temporal trends in the outcomes and individual morbidities were assessed by PTB subtype. Logistic regression yielded adjusted odds ratios (AOR) per 1 year change in outcome and 95% CI.ResultsThe rate of PTB following PPROM and spontaneous labour declined, while clinician-initiated PTB increased (all p<0.01). Overall neonatal mortality remained unchanged (1.3%; AOR 0.99, CI 0.95 to 1.02), though gestational age-specific mortality following clinician-initiated PTB declined at 32–33 weeks (AOR 0.85, CI 0.74 to 0.97) and increased at 34–36 weeks (AOR 1.10, CI 1.01 to 1.20). The overall rate of the composite outcome increased (from 7.9% to 11.9%; AOR 1.06, CI 1.05 to 1.08). Among late preterm infants, combined mortality or severe morbidity increased following PPROM (AOR 1.13, CI 1.08 to 1.18), spontaneous labour (AOR 1.09, CI 1.06 to 1.13) and clinician-initiated delivery (AOR 1.10, CI 1.07 to 1.13). Neonatal sepsis rates increased among all preterm infants (AOR 1.09, CI 1.08 to 1.11).ConclusionsTiming of obstetric interventions is associated with infant health outcomes at preterm. The temporal decline in late PTB among singleton infants was associated with increased mortality among late preterm infants born following clinician-initiated delivery and increased combined mortality or severe morbidity among all late preterm infants, mainly due to increased rate of sepsis.

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Maternal Factors and Neonatal Mortality and Morbidity Associated with Late Preterm Birth

Journal of King Abdulaziz University-Medical Sciences ◽

10.4197/med.22-4.1 ◽

2015 ◽

Vol 22 (4) ◽

pp. 1-8

Author(s):

Heidi K. Al-Wassia

Keyword(s):

Risk Factors ◽

Preterm Birth ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Adverse Outcomes ◽

Late Preterm ◽

University Hospital ◽

Mortality And Morbidity ◽

Late Preterm Infants ◽

Late Preterm Birth

The objective of this study is to ascertain risk factors and outcomes associated with late preterm birth. A 1:1 matched case-control study of mothers who delivered at 34+0 to 36+6 weeks gestation (cases) and at term (controls) at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between June 1st, 2014 and March 30th, 2015. We enrolled 53 cases and 53 controls. Mothers of late preterm infants were older (p = 0.03), with higher parity (p = 0.04), body mass index (p = 0.01) and multiple pregnancies (p = < 0.001) compared to mothers of infants born at term. A higher proportion of hypertension and (p = 0.01) and premature rupture of membrane (p = < 0.001) preceded late preterm deliveries. Cesarean section frequency was greater in late preterm infants (p = 0.002). Late preterm infants were admitted to the neonatal intensive care unit more frequently than their term counterparts (p = < 0.001), had more respiratory adverse outcomes (p = 0.006) and longer hospital stay (p = 0.001). Late preterm birth is a substantial perinatal health problem warranting a closer look at eff orts to improve prenatal care strategies to reduce risk factors associated with it and prevent non-medically indicated premature birth.

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Vitamin A supplementation for prevention of mortality and morbidity in moderate and late preterm infants

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd013322 ◽

2019 ◽

Author(s):

Abhijeet A Rakshasbhuvankar ◽

Sanjay K Patole ◽

Karen Simmer ◽

Jane Pillow

Keyword(s):

Vitamin A ◽

Preterm Infants ◽

Late Preterm ◽

Vitamin A Supplementation ◽

Mortality And Morbidity ◽

Late Preterm Infants

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An Investigation of Neonatal Mortality and its Main Risk Factors in Hospitalized Late Preterm Infants

10.21203/rs.3.rs-602867/v1 ◽

2021 ◽

Author(s):

Behnaz Basiri ◽

zohre sadeghian ◽

Nasrollah Pezeshki ◽

Mohammad Ali Seif Rabie ◽

Tara lakpour

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Respiratory Distress Syndrome ◽

Neonatal Mortality ◽

Preterm Infants ◽

Congenital Heart ◽

Distress Syndrome ◽

Late Preterm ◽

Cns Involvement ◽

Late Preterm Infants

Abstract Background: Late preterm infants are born at a gestational age between 34+1 and 36+6 weeks, they have higher morbidity and mortality rates than term infants (gestational age ≥37 weeks). Methods: In this retrospective, cross-sectional study the medical records of late preterm infant hospitalized in Fatemieh hospital, Hamadan- Iran, were extracted during a one-year period (March 2018– March 2019). Demographic information including sex, birth weight, causes of hospitalization and complications of the disease, length of stay, and outcome were assessed. Results: Out of 150 infants studied in this research, 52% were female and 48% were male. Mean weight was 2775±572 gr with mean admission days of 9.1±4.7 days. Respiratory distress syndrome (RDS) was the most common cause of admission (80.7%). Neonatal mortality rate was overall 7.3%. According to logistic regression, need for resuscitation and ventilation, central nervous system (CNS) involvement (seizure) (P≤0.001), congenital heart disease (P≤0.001), need to surfactant administration (P=0.034), pneumonia (P=0.018), feeding problems (P≤0.001), hypoglycemia (P=0.048) and septicemia (P≤0.001), could all possibly correlate with the occurrence of death in late-preterm infants.Conclusion: Neonatal mortality is high in late preterm infants and can be predicted by the need to intensive supports for respiratory distress syndrome, CNS involvement, congenital heart disease, and septicemia.

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Late Preterm Infants Require Preventive Vigilance

Pediatric News ◽

10.1016/s0031-398x(08)70183-8 ◽

2008 ◽

Vol 42 (4) ◽

pp. 30-31

Author(s):

DOUG BRUNK

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Late Preterm Infants

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Faculty Opinions recommendation of Early school-age outcomes of late preterm infants.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1159678.621076 ◽

2009 ◽

Author(s):

Helen Kay

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

School Age ◽

Late Preterm Infants ◽

Early School ◽

Early School Age

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Respiratory distress management in moderate and late preterm infants: The NEOBS Study

Archives de Pédiatrie ◽

10.1016/j.arcped.2021.03.010 ◽

2021 ◽

Author(s):

T. Debillon ◽

P. Tourneux ◽

I. Guellec ◽

P.-H. Jarreau ◽

C. Flamant

Keyword(s):

Respiratory Distress ◽

Preterm Infants ◽

Late Preterm ◽

Late Preterm Infants

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Neurodevelopmental Outcomes at 18 Months of Corrected Age for Late Preterm Infants Born at 34 and 35 Gestational Weeks

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020640 ◽

2021 ◽

Vol 18 (2) ◽

pp. 640 ◽

Cited By ~ 1

Author(s):

Ruka Nakasone ◽

Kazumichi Fujioka ◽

Yuki Kyono ◽

Asumi Yoshida ◽

Takumi Kido ◽

...

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Psychomotor Development ◽

Youden Index ◽

Chromosomal Anomalies ◽

Clinical Factors ◽

Neurodevelopmental Outcomes ◽

Late Preterm Infants ◽

Significant Difference ◽

Severe Hyperbilirubinemia

To date, the difference in neurodevelopmental outcomes between late preterm infants (LPI) born at 34 and 35 gestational weeks (LPI-34 and LPI-35, respectively) has not been elucidated. This retrospective study aimed to evaluate neurodevelopmental outcomes at 18 months of corrected age for LPI-34 and LPI-35, and to elucidate factors predicting neurodevelopmental impairment (NDI). Records of all LPI-34 (n = 93) and LPI-35 (n = 121) admitted to our facility from 2013 to 2017 were reviewed. Patients with congenital or chromosomal anomalies, severe neonatal asphyxia, and without developmental quotient (DQ) data were excluded. Psychomotor development was assessed as a DQ using the Kyoto Scale of Psychological Development at 18 months of corrected age. NDI was defined as DQ < 80 or when severe neurodevelopmental problems made neurodevelopmental assessment impossible. We compared the clinical characteristics and DQ values between LPI-34 (n = 62) and LPI-35 (n = 73). To elucidate the factors predicting NDI at 18 months of corrected age, we compared clinical factors between the NDI (n = 17) and non-NDI (n = 118) groups. No significant difference was observed in DQ values at 18 months of corrected age between the groups in each area and overall. Among clinical factors, male sex, intraventricular hemorrhage (IVH), hyperbilirubinemia, and severe hyperbilirubinemia had a higher prevalence in the NDI group than in the non-NDI group, and IVH and/or severe hyperbilirubinemia showed the highest Youden Index values for predicting NDI. Based on the results of this study, we can conclude that no significant difference in neurodevelopmental outcomes at 18 months of corrected age was observed between LPI-34 and LPI-35. Patients with severe hyperbilirubinemia and/or IVH should be considered to be at high risk for developing NDI.

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