Late prematuriteit: een risicopopulatie?

2021 ◽  
Author(s):  
B. DEVOCHT ◽  
K. SMETS ◽  
L. GARABEDIAN
Keyword(s):  
Preterm Infants ◽  
Relative Size ◽  
Late Preterm ◽  
Late Preterm Infant ◽  
Term Infants ◽  
Feeding Difficulties ◽  
Developmental Problems ◽  
Late Preterm Infants ◽  
Near Term

Late preterm infant: a population at risk? Late preterm infants, infants born between 34 0/7 and 36 6/7 weeks of gestation, were called near term before 2005, which may lead to the assumption that they are mature and an underestimation of their risks. Late preterm infants are physiologically and metabolically immature. Compared to term infants they have increased morbidity rates, including problems such as hypothermia, hypoglycemia, hyperbilirubinemia, feeding difficulties and respiratory and immunological issues. In late preterm infants there are increased mortality rates, prolonged hospitalizations at birth, more readmissions and higher healthcare costs. The infants also have a higher risk of neurological and developmental problems and long-term respiratory, cardiovascular and metabolic difficulties. Despite their relative size and apparently mature appearance, late preterm infants should not be treated like term infants. They require careful monitoring immediately after birth, as well as during childhood and even adolescence. Child-birth should not be scheduled during the late preterm period without medical indication. The risk of continuing the pregnancy must be weighed against the risk of premature birth. The prevention and a better monitoring of late preterm infants can lead to healthcare savings.

Feeding Challenges in the Late Preterm Infant

2010 ◽  
Vol 29 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Karen Cleaveland
Keyword(s):  
Preterm Infant ◽  
Preterm Infants ◽  
Preterm Births ◽  
Late Preterm ◽  
Late Preterm Infant ◽  
Temperature Instability ◽  
Feeding Difficulties ◽  
Late Preterm Infants ◽  
Hospital Stays ◽  
Prolonged Hospital

A late preterm infant is defined as one born between 34 and 36 6/7 weeks of completed gestation. The rate of late preterm births has risen 18 percent since the late 1990s. Data are beginning to emerge concerning morbidity rates and the risks these newborns face with regard to feeding difficulties, temperature instability, hypoglycemia, and hyperbilirubinemia. Feeding challenges place these vulnerable infants at risk for prolonged hospital stays and readmission after discharge. To better address the unique needs of late preterm infants, providers should establish individual feeding orders. This article offers research-based suggestions for caring for these infants in the newborn nursery and the postpartum unit as well as parent teaching guidelines.

scholarly journals Trends in Costs of Birth Hospitalization and Readmissions for Late Preterm Infants

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 127
Author(s):  
Rebecca R. Speer ◽  
Eric W. Schaefer ◽  
Mahoussi Aholoukpe ◽  
Douglas L. Leslie ◽  
Chintan K. Gandhi
Keyword(s):  
Preterm Infants ◽  
Private Insurance ◽  
The United States ◽  
Late Preterm ◽  
Term Infants ◽  
Late Preterm Infants ◽  
Hospitalization Costs ◽  
Analysis Of Claims Data ◽  
Mean Cost ◽  
Birth Hospitalization

Background: The objective is to study previously unexplored trends of birth hospitalization and readmission costs for late preterm infants (LPIs) in the United States between 2005 and 2016. Methods: We conducted a retrospective analysis of claims data to study healthcare costs of birth hospitalization and readmissions for LPIs compared to term infants (TIs) using a large private insurance database. We used a generalized linear regression model to study birth hospitalization and readmission costs. Results: A total of 2,123,143 infants were examined (93.2% TIs; 6.8% LPIs). The proportion of LPIs requiring readmission was 4.2% compared to 2.1% of TIs, (p < 0.001). The readmission rate for TIs decreased during the study period. LPIs had a higher mean cost of birth hospitalization (25,700 vs. 3300 USD; p < 0.001) and readmissions (25,800 vs. 14,300 USD; p < 0.001). For LPIs, birth hospitalization costs increased from 2007 to 2013, and decreased since 2014. Conversely, birth hospitalization costs of TIs steadily increased since 2005. The West region showed higher birth hospitalization costs for LPIs. Conclusions: LPIs continue to have a higher cost of birth hospitalization and readmission compared to TIs, but these costs have decreased since 2014. Standardization of birth hospitalization care for LPIs may reduce costs and improve quality of care and outcomes.

scholarly journals Effects of Sex and Mild Intrainsult Hypothermia on Neuropathology and Neural Reorganization following Neonatal Hypoxic Ischemic Brain Injury in Rats

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Amanda L. Smith ◽  
Ted S. Rosenkrantz ◽  
R. Holly Fitch
Keyword(s):  
Preterm Infants ◽  
Late Preterm ◽  
Female Rats ◽  
Future Research ◽  
Term Infants ◽  
Behavioral Deficits ◽  
Clinical Issue ◽  
Late Preterm Infants ◽  
Male And Female Rats ◽  
Compare And Contrast

Hypoxia ischemia (HI) is a recognized risk factor among late-preterm infants, with HI events leading to varied neuropathology and cognitive/behavioral deficits. Studies suggest a sex difference in the incidence of HI and in the severity of subsequent behavioral deficits (with better outcomes in females). Mechanisms of a female advantage remain unknown but could involve sex-specific patterns of compensation to injury. Neuroprotective hypothermia is also used to ameliorate HI damage and attenuate behavioral deficits. Though currently prescribed only for HI in term infants, cooling has potential intrainsult applications to high-risk late-preterm infants as well. To address this important clinical issue, we conducted a study using male and female rats with a postnatal (P) day 7 HI injury induced under normothermic and hypothermic conditions. The current study reports patterns of neuropathology evident inpostmortemtissue. Results showed a potent benefit of intrainsult hypothermia that was comparable for both sexes. Findings also show surprisingly different patterns of compensation in the contralateral hemisphere, withincreasesin hippocampal thickness in HI females contrastingreducedthickness in HI males. Findings provide a framework for future research to compare and contrast mechanisms of neuroprotection and postinjury plasticity in both sexes following a late-preterm HI insult.

Admissions and Emergency Visits by Late Preterm Singletons and Twins in the First 5 Years: A Population-Based Cohort Study

2019 ◽  
Author(s):  
Tetsuya Isayama ◽  
Daria O'Reilly ◽  
Joseph Beyene ◽  
Shoo K. Lee ◽  
Prakesh S. Shah ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Infants ◽  
Population Based ◽  
Late Preterm ◽  
Administrative Database ◽  
Term Infants ◽  
Emergency Visits ◽  
Late Preterm Infants ◽  
Adjusted Incidence Rate ◽  
The Difference

Abstract Objective To compare admission and emergency visits of late preterm (340/7–366/7 weeks) versus term infants (370/7–416/7 weeks) in the first 5 years. Study Design This population-based cohort study included all singletons and twins born alive at 340/7 to 416/7 weeks' gestation registered in a health administrative database in Ontario, Canada, between April 1, 2002 and December 31, 2012. Admissions and emergency visits from initial postnatal discharge to 5 years were compared between late preterm and term infants adjusting for maternal and infant characteristics. Results A total of 1,316,931 infants (75,364 late preterm infants) were included. Late preterm infants had more frequent admissions than term infants in the first 5 years in both singletons (adjusted incidence rate ratio [95% confidence interval] = 1.46 [1.42–1.49]) and twins (1.21 [1.11–1.31]). The difference in admissions between late preterm and term infants were smaller in twins than singletons and decreased with children's ages. Twins had less frequent admissions than singletons for late preterm infants, but not for term infants. The emergency visits were more frequent in late preterm than term infants in all the periods. Conclusion Admissions and emergency visits were more frequent in late preterm than term infants through the first 5 years. Admissions were less frequent in late preterm twins than singletons.

scholarly journals Competence and Responsiveness in Mothers of Late Preterm Infants Versus Term Infants

2013 ◽  
Vol 42 (3) ◽  
pp. 301-310 ◽  
Author(s):  
Brenda Baker ◽  
Jacquelin.M. McGrath ◽  
Rita Pickler ◽  
Nancy Jallo ◽  
Stephen Cohen
Keyword(s):  
Preterm Infants ◽  
Late Preterm ◽  
Term Infants ◽  
Late Preterm Infants

scholarly journals Morbidity profile and immediate outcome of late preterm neonates compared to term neonates in a rural tertiary care hospital of Gujarat

2017 ◽  
Vol 4 (4) ◽  
pp. 1329 ◽  
Author(s):  
Manish Rasania ◽  
Prasad Muley
Keyword(s):  
Preterm Infants ◽  
Tertiary Care ◽  
Preterm Births ◽  
Full Term ◽  
Late Preterm ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Term Infants ◽  
Term Neonates ◽  
Late Preterm Infants

Background: Late premature infants are born near term, but are immature. As a consequence, late preterm infants are at higher risk than term infants to develop morbidities. Although late preterm infants are the largest subgroup of preterm infants, there is a very limited data available on problems regarding late preterm infants in rural India.Methods: This is a retrospective cohort study using previously collected data from neonates born at Dhiraj Hospital and neonates who were born outside but admitted at SNCU of Dhiraj Hospital, Piparia, Vadodara district, Gujarat, India between January 2015 to December 2015.Results: 168 late preterm infants and 1025 term infants were included in this study. The need for SNCU admission is significantly higher in late preterm compared to full term (41.07% vs 2.04%). Morbidities were higher in late preterm neonates compared to full term neonates. Sepsis (4.76% vs 1.07%), TTN (10.11% vs 2.04%), hyperbilirubinemia (19.04% vs 9.36%), RDS (1.78% vs 0.09%), hypoglycemia (1.78% vs 0.29%), PDA (1.78% vs 0.58%), risk of major congenital malformation (2.38% vs 0.58%). Need for respiratory support was 5.95% in late preterm vs 2.04% in full term neonates. Immediate neonatal outcome in terms of death and DAMA (non-salvageable) cases was poor in late preterm neonates compared to full term neonates (1.19% vs 0.78%).Conclusions: Late preterm neonates are at higher risk of morbidities and mortalities. They require special care. Judicious obstetric decisions are required to prevent late preterm births. 

scholarly journals A shorter breastfeeding duration in late preterm infants than term infants during the first year

2020 ◽  
Author(s):  
Rakel B. Jonsdottir ◽  
Helga Jonsdottir ◽  
Brynja Orlygsdottir ◽  
Renée Flacking
Keyword(s):  
Preterm Infants ◽  
Late Preterm ◽  
Breastfeeding Duration ◽  
First Year ◽  
Term Infants ◽  
Late Preterm Infants
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