Archives of Gynecology and Obstetrics

, Volume 286, Issue 3, pp 619–626

The underestimation of immaturity in late preterm infants

Authors

    • Department of Prenatal and Perinatal MedicineAsklepios Clinic
  • Kathrin Herz
    • Asklepios Proresearch Department
  • Bozena Liedtke
    • Department of NeonatologyAsklepios Clinic
  • Peter Wohlmuth
    • Asklepios Proresearch Department
  • Stephan Schmidt
    • Department of Obstetrics and Perinatal MedicinePhilipps University Marburg
  • Bernhard-Joachim Hackeloeer
    • Department of Prenatal and Perinatal MedicineAsklepios Clinic
Maternal-Fetal Medicine

DOI: 10.1007/s00404-012-2366-7

Cite this article as:
Hellmeyer, L., Herz, K., Liedtke, B. et al. Arch Gynecol Obstet (2012) 286: 619. doi:10.1007/s00404-012-2366-7

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.

Keywords

ObstetricsLate pretermsNeonatological outcomeImmaturity

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

Copyright information

© Springer-Verlag 2012