Do Gestational Age Dating Criteria Matter in Medically Indicated Late Preterm, Early-Term, and Full-Term Inductions of Labor?

BackgroundPreterm, and more recently early term, birth has been identified as a risk factor for poor health. Whether the sequelae of late preterm or early term birth extends to poor mental health and well-being in adolescence is unclear and has not been systematically assessed.MethodLinear regression was used to assess the adjusted associations of gestational age (very/moderate preterm (<34 weeks, n=85), late preterm (34–36 weeks, n=305), early term (37–38 weeks, n=2228), full term (39–40 weeks, n=4018), late term (41 weeks, n=809), post-term (≥42 weeks, n=213)) with self-reported self-esteem at ∼11 years (n=6935), parent-reported Rutter score assessing the common emotional and behavioural problems at ∼7 years (n=6292) and ∼11 years (n=5596) and self-reported depressive symptoms at ∼13 years (n=5795) in a population-representative Hong Kong Chinese birth cohort ‘Children of 1997’ where gestational age has little social patterning.ResultsVery/moderate preterm birth was associated with higher Rutter subscore for hyperactivity (ß coefficients 0.5, 95% CI 0.01 to 1.00) at ∼7 years but not at ∼11 years, adjusted for sex, age, socio-economic position, parents’ age at birth, birth order and secondhand smoke exposure. Similarly adjusted, late preterm, early term, late term and post-term birth were not associated with self-esteem or depressive symptoms.ConclusionsIn a population-representative birth cohort from a non-Western-developed setting, gestational age had few associations with mental health and well-being in adolescence, whereas very preterm birth was specifically associated with hyperactivity in childhood. Inconsistencies with studies from Western settings suggest setting specific unmeasured confounding may underlie any observed associations.

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Breastfeeding Outcomes, Self-Efficacy, and Satisfaction Among Low-Income Women With Late-Preterm, Early-Term, and Full-Term Infants

Journal of Obstetric Gynecologic & Neonatal Nursing ◽

10.1016/j.jogn.2021.06.010 ◽

2021 ◽

Author(s):

Azza H. Ahmed ◽

Wilaiporn Rojjanasrirat

Keyword(s):

Low Income ◽

Self Efficacy ◽

Full Term ◽

Late Preterm ◽

Term Infants ◽

Early Term ◽

Low Income Women

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Gestational Age and Developmental Risk in Moderately and Late Preterm and Early Term Infants

PEDIATRICS ◽

10.1542/peds.2014-1957 ◽

2015 ◽

Vol 135 (4) ◽

pp. e835-e841 ◽

Cited By ~ 28

Author(s):

L. Schonhaut ◽

I. Armijo ◽

M. Perez

Keyword(s):

Gestational Age ◽

Late Preterm ◽

Term Infants ◽

Developmental Risk ◽

Early Term

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Outcomes of infants born near term

Archives of Disease in Childhood ◽

10.1136/archdischild-2015-309584 ◽

2016 ◽

Vol 102 (2) ◽

pp. 194-198 ◽

Cited By ~ 16

Author(s):

Jane V Gill ◽

Elaine M Boyle

Keyword(s):

Gestational Age ◽

Epidemiological Studies ◽

Adverse Outcomes ◽

Late Preterm ◽

Current Evidence ◽

Early Term ◽

Risk Of Mortality ◽

Adverse Neonatal Outcomes ◽

Near Term ◽

Term Births

Most research on outcomes of preterm birth has centred on babies born at <32 weeks gestation and at highest risk of mortality and serious morbidity. Recent years have seen a dramatic increase in studies focusing on late preterm infants (34–36 weeks gestation). Early epidemiological studies demonstrated increased risks of mortality and adverse neonatal outcomes in this group, prompting further investigations. These increased risks have been confirmed and more recent studies have also included babies born at 37–38 weeks, now defined as ‘early-term’ births. It now seems that it is inappropriate to consider term and preterm as a dichotomy; gestational age rather represents a continuum in which risk and severity of adverse outcomes increase with decreasing gestational age, but where measurable effects can be detected even very close to full term. In this review, we summarise current evidence for the outcomes of infants born at late preterm and early-term gestations.

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1526. The economic impact of respiratory syncytial virus (RSV) in infants in the United States: systematic literature review

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1706 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S764-S764

Author(s):

Diana Bowser ◽

Reissa Gervasio ◽

Elizabeth Glaser ◽

Dhwani Harihan ◽

Katie Rowlands ◽

...

Keyword(s):

Respiratory Syncytial Virus ◽

Literature Review ◽

Preterm Infants ◽

Gestational Age ◽

Medical Costs ◽

Full Term ◽

Late Preterm ◽

Term Infants ◽

Late Preterm Infants ◽

Syncytial Virus

Abstract Background Respiratory syncytial virus (RSV) is a human orthopneumovirus spread by direct contact with symptomatic, infected individuals. An estimated 587,000 RSV LRTIs result in inpatient or outpatient encounters annually among US infants (Rainisch et al 2019). The health care costs associated with RSV include medical costs to insurers, governments, and households, travel, and loss of wages. Initial summary of Inpatient and Ambulatory Medical Costs p Infant w RSV.JPG Jun 17th, 2020 @ 2:44 PM 852 x 572 122.3 Kb Methods A systematic literature review of the costs associated with children who have RSV was conducted. Following PRISMA methodology, key search terms were searched within article titles and abstracts through PubMed, EconLit, and Scopus. A total of 1,942 unique abstracts were screened independently by two authors and reduced to 180 articles after applying inclusion and exclusion criteria. The number of included articles after reviewing the full text was 66. Costing results were adjusted to USD2020 based on the Medical Care Consumer Price Index. Results Costing results were reported mainly for medical costs in inpatient settings. Initial results show that annual mean inpatient costs per RSV patient range among individual studies from $9,825 (SD=$25,227) for full term infants to $26,120 (SD unspecified) for late preterm infants (Table 1). Costing results vary by gestational age, with late preterm infants having an annual mean inpatient cost almost 1.6 times that of a full term infant. Inpatient costs for RSV infants are higher for commercial pay versus Medicaid, for both full term infants (commercial mean=$16,489 SD=$31,068, Medicaid mean=$10,291 SD=$64,625) and late preterm infants (commercial mean=$23,836; SD=$43,709, Medicaid mean=$18,864 SD=$28,716). Annual RSV ambulatory costs per infant vary between $4,371 (SD=$13,411) and $19,963 (SD=$27,269), depending on gestational age. Other relevant RSV costs include preventative drug costs, such as palivizumab (average $11,954 per infant). Conclusion The literature describes the economic impact of RSV primarily for hospitalization of children with underlying comorbidities. There is a need to better understand costing results for RSV, including the burden in ambulatory settings and indirect costs to families affected. Disclosures All Authors: No reported disclosures

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Long term cognitive outcomes of early term (37-38 weeks) and late preterm (34-36 weeks) births: A systematic review

Wellcome Open Research ◽

10.12688/wellcomeopenres.12783.1 ◽

2017 ◽

Vol 2 ◽

pp. 101 ◽

Cited By ~ 7

Author(s):

Sarah R. Murray ◽

Susan D. Shenkin ◽

Kirsten McIntosh ◽

Jane Lim ◽

Benjamin Grove ◽

...

Keyword(s):

Systematic Review ◽

Preterm Births ◽

Full Term ◽

Cognitive Outcomes ◽

Cognitive Testing ◽

Cognitive Outcome ◽

Late Preterm ◽

Early Term ◽

Term Births

Background: There is a paucity of evidence regarding long-term outcomes of late preterm (34-36 weeks) and early term (37-38 weeks) delivery. The objective of this systematic review was to assess long-term cognitive outcomes of children born at these gestations. Methods: Four electronic databases (Medline, Embase, clinicaltrials.gov and PsycINFO) were searched. Last search was 5th August 2016. Studies were included if they reported gestational age, IQ measure and the ages assessed. The protocol was registered with the International prospective register of systematic reviews (PROSPERO Record CRD42015015472). Two independent reviewers assessed the studies. Data were abstracted and critical appraisal performed of eligible papers. Results: Of 11,905 potential articles, seven studies reporting on 41,344 children were included. For early term births, four studies (n = 35,711) consistently showed an increase in cognitive scores for infants born at full term (39-41 weeks) compared to those born at early term (37-38 weeks) with increases for each week of term (difference between 37 and 40 weeks of around 3 IQ points), despite differences in age of testing and method of IQ/cognitive testing. Four studies (n = 5644) reporting childhood cognitive outcomes of late preterm births (34 – 36 weeks) also differed in study design (cohort and case control); age of testing; and method of IQ testing, and found no differences in outcomes between late preterm and term births, although risk of bias was high in included studies. Conclusion: Children born at 39-41 weeks have higher cognitive outcome scores compared to those born at early term (37-38 weeks). This should be considered when discussing timing of delivery. For children born late preterm, the data is scarce and when compared to full term (37-42 weeks) did not show any difference in IQ scores.

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