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

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.

Practice Variation in Antenatal Steroid Administration for Anticipated Late Preterm Birth: A Physician Survey

2018 ◽  
Vol 36 (02) ◽  
pp. 200-204 ◽  
Author(s):  
Mark Clapp ◽  
Kim Boggess ◽  
Anjali Kaimal ◽  
Carrie Snead ◽  
Jay Schulkin ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Neonatal Intensive Care ◽  
Practice Variation ◽  
Adverse Outcomes ◽  
Late Preterm ◽  
Maternal Fetal Medicine ◽  
Electronic Survey ◽  
Late Preterm Birth ◽  
Antenatal Steroid ◽  
Insulin Dependent

Objective The objective of this study was to measure knowledge and practice variation in late preterm steroid use. Study Design Electronic survey of American College of Obstetricians and Gynecologists (ACOG) members about data supporting the ACOG/Society for Maternal-Fetal Medicine (SMFM) recommendations and practice when caring for women with anticipated late preterm birth (PTB), 340/7 to 366/7 weeks. Results Of 352 administered surveys, we obtained 193 completed responses (55%); 82.5% were generalist obstetrician-gynecologists (OB/GYNs), and 42% cared for women with anticipated late PTB at least weekly. Most believed that late preterm steroids provided benefit by reducing respiratory distress syndrome (93%), transient tachypnea of the newborn (83%), and neonatal intensive care unit admission (82%). More than half administered late preterm steroids to women with multiple gestations (73%), and pregestational diabetes (55–80%) depending on glycemic control. OB/GYNs administered steroids to insulin-dependent and poorly controlled diabetics more often than MFMs (75 vs. 46% and 59 vs. 37% respectively, p < 0.05 for both). While providers believed there was increased maternal hyperglycemia (88%) and neonatal hypoglycemia (59%), 88% believed neonatal respiratory benefits outweighed these risks. Respondents agreed research is needed to determine who are appropriate candidates (77%) and how to minimize adverse outcomes (82%). Conclusion Most providers are administering late preterm steroids to all women, even those populations who have been excluded from previous trials. Despite widespread use, providers believe more research is needed to optimize management.

scholarly journals Influence of a Breastfeeding Coaching Program on the Breastfeeding Rates and Neonatal Morbidity in Late Preterm Infants

2020 ◽  
Vol 26 (3) ◽  
pp. 376-384
Author(s):  
Gun Ja Jang
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Neonatal Morbidity ◽  
Late Preterm ◽  
University Hospital ◽  
Control Group ◽  
Late Preterm Infants ◽  
Breastfeeding Rate ◽  
Breastfeeding Rates ◽  
Experimental Group

Purpose: This study aimed to determine the influence of a breastfeeding coaching program (BCP) for mothers of late preterm infants (LPIs) on the breastfeeding rate and neonatal morbidity within 1 month after discharge.Methods: This was a non-randomized quasi-experimental study with a time series design. The participants were 40 LPIs and their mothers who were hospitalized in a neonatal intensive care unit at a university hospital. Nineteen LPIs were assigned to the control group, and 21 to the experimental group. The mothers of the LPIs in the experimental group received the BCP once on the discharge day and then once a week for 1 month. Neonatal morbidity was defined as an outpatient department or emergency room visit due to an LPI's health problem.Results: The breastfeeding rate in the experimental group was significantly higher than in the control group at the fourth week after discharge (<i>x</i><sup>2</sup>=7.17, <i>p</i>=.028). Five and two LPIs in the control group and the experimental group, respectively, visited a hospital due to neonatal jaundice. Neonatal morbidity was not significantly different between the two groups (<i>x</i><sup>2</sup>=1.95, <i>p</i>=.164).Conclusion: The BCP was useful for improving the breastfeeding rates of LPIs and may have potential to reduce neonatal morbidity.

scholarly journals Perinatal Risk Factors for Postnatal Weight Loss in Late Preterm Infants

2019 ◽  
Vol 26 (4) ◽  
pp. 198-203
Author(s):  
Seong Phil Bae ◽  
Jun Hwan Song ◽  
Won-Ho Hahn ◽  
Ji Won Koh ◽  
Ho Kim
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Preterm Infants ◽  
Late Preterm ◽  
Perinatal Risk Factors ◽  
Perinatal Risk ◽  
Late Preterm Infants

One-year neurodevelopmental outcome of very and late preterm infants: Risk factors and correlation with maternal stress

2015 ◽  
Vol 39 ◽  
pp. 11-20 ◽  
Author(s):  
Maria Franca Coletti ◽  
Barbara Caravale ◽  
Corinna Gasparini ◽  
Francesco Franco ◽  
Francesca Campi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Infants ◽  
Maternal Stress ◽  
Neurodevelopmental Outcome ◽  
Late Preterm ◽  
Late Preterm Infants ◽  
One Year

scholarly journals Temporal trends in neonatal mortality and morbidity following spontaneous and clinician-initiated preterm birth in Washington State, USA: a population-based study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023004 ◽  
Author(s):  
Lindsay L Richter ◽  
Joseph Ting ◽  
Giulia M Muraca ◽  
Anne Synnes ◽  
Kenneth I Lim ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Preterm Infants ◽  
Temporal Trends ◽  
Population Based ◽  
Washington State ◽  
Late Preterm ◽  
Population Based Study ◽  
Mortality And Morbidity ◽  
Late Preterm Infants ◽  
Spontaneous Labour

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.

Short-Term Outcomes following Standardized Admission of Late Preterm Infants to Family-Centered Care

2019 ◽  
Author(s):  
Jonathan Reiss ◽  
Pavan S. Upadhyayula ◽  
Hyeri You ◽  
Ronghui Xu ◽  
Lisa M. Stellwagen
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Transitions Of Care ◽  
Late Preterm ◽  
Family Centered Care ◽  
Short Term ◽  
Late Preterm Infants ◽  
Car Seat ◽  
Centered Care ◽  
Family Centered

Abstract Objective The study compares the short-term outcomes of late preterm infants (LPI) at an academic center in San Diego, California after a change in protocol that eliminated a previously mandatory 12-hour neonatal intensive care unit (NICU) observation period after birth. Study Design This is a retrospective observational study examining all LPI born with gestational age 35 to 366/7 weeks between October 1, 2016 and October 31, 2017. A total of 189 infants were included in the review. Short-term outcomes were analyzed before and after the protocol change. Results Transfers to the NICU from family-centered care (FCC) were considerably higher (23.2%) following the protocol change, compared to before (8.2%). More infants were transferred to the NICU for failed car seat tests postprotocol compared to preprotocol. Length of stay before the protocol change was 5.13 days compared to 4.80 days after. Conclusion LPI are vulnerable to morbidities after delivery and through discharge. We found an increase in failed car seat tests in LPI cared for in FCC after elimination of a mandatory NICU observation after birth. The transitions of care from delivery to discharge are key checkpoints in minimizing complications.

scholarly journals Behavioural outcomes at 3 years of age among late preterm infants admitted to neonatal intensive care: a cohort study

2014 ◽  
Vol 99 (5) ◽  
pp. F359-F365 ◽  
Author(s):  
Jackie Boylan ◽  
Fiona A Alderdice ◽  
Jennifer E McGowan ◽  
Stanley Craig ◽  
Oliver Perra ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Late Preterm ◽  
Late Preterm Infants
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