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The underestimation of immaturity in late preterm infants

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Late preterm infants with gestational ages between \( 34\frac{0}{7} \) and \( 36\frac{6}{7} \) weeks are known to be at higher risk of mortality and morbidity than term newborns. This study aims to investigate the nature and frequency of neonatological complications in the late preterm population resulting in neonatal intensive care unit admissions as well as to draw obstetrical conclusions from the results.

Methods

Neonatological outcomes of 893 consecutively born late preterm infants were evaluated and classified by the frequency of occurrence in relation to potential maternal or fetal risk factors.

Results

Out of 893 late preterm infants, 528 (59.1 %) required intensive neonatal care. The incidence of apnea and bradycardia, the occurrence of feeding difficulties and the requirement of continuous positive airway pressure (CPAP) were inversely proportional to gestational age (p < 0.001). Gestational diabetes of the mother was more frequently associated with hypoglycemia (p < 0.001), but showed a reduced risk of hypothermia (p < 0.001). Small for gestational age neonates had a significantly lower rate of respiratory disorders (p < 0.001), but were more often affected by feeding difficulties (p < 0.01). Normal vaginal delivery had a significant advantage with regard to the necessity of CPAP (p < 0.01) and the occurrence of feeding difficulties (p < 0.05). Infants born by cesarean section were at higher risk of hypoglycemia (p < 0.001), but at lower risk of hyperbilirubinemia (p < 0.001).

Conclusions

The high risk of a problematic neonatological outcome in late preterms requires fundamental reconsideration. All efforts to prolong a pregnancy should be made beyond the 34th week of gestation.

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Abbreviations

NICU:

Neonatal intensive care unit

CPAP:

Continuous positive airway pressure

Perc90:

Birth weight over the 90th percentile

SGA10:

Small for gestational age; birth weight below the 10th percentile

IUGR:

Intrauterine growth restriction

PPROM:

Preterm premature rupture of membranes

CPAP:

Continuous positive airway pressure

APNBRA:

Apnea and bradycardia

RESP:

Respiratory disorder

HYPOGLY:

Hypoglycemia

HYPOTHERM:

Hypothermia

FEEDDIFF:

Feeding difficulties

HYPERBILI:

Hyperbilirubinemia

ANTIBIOT:

Use of antibiotics

GW:

Week of gestation

GDM:

Gestational diabetes mellitus

M1:

Mode 1

M2:

Mode 2

M3:

Mode 3

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Acknowledgments

No funding has been received for this study.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Prenatal and Perinatal Medicine, Asklepios Clinic, Hamburg-Barmbek, Germany

    Lars Hellmeyer & Bernhard-Joachim Hackeloeer

  2. Asklepios Proresearch Department, Hamburg, Germany

    Kathrin Herz & Peter Wohlmuth

  3. Department of Neonatology, Asklepios Clinic, Hamburg-Barmbek, Germany

    Bozena Liedtke

  4. Department of Obstetrics and Perinatal Medicine, Philipps University Marburg, Marburg, Germany

    Stephan Schmidt

  5. Wilhelm-Roser-Str. 40, 35037, Marburg, Germany

    Lars Hellmeyer

Authors
  1. Lars Hellmeyer
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  2. Kathrin Herz
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  4. Peter Wohlmuth
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  5. Stephan Schmidt
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  6. Bernhard-Joachim Hackeloeer
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Correspondence to Lars Hellmeyer.

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Hellmeyer, L., Herz, K., Liedtke, B. et al. The underestimation of immaturity in late preterm infants. Arch Gynecol Obstet 286, 619–626 (2012). https://doi.org/10.1007/s00404-012-2366-7

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  • DOI: https://doi.org/10.1007/s00404-012-2366-7

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