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Indian Pediatrics

, Volume 54, Issue 8, pp 629–634 | Cite as

Physical growth, morbidity profile and mortality among healthy late preterm neonates

  • Priyanka Gupta
  • Ritu Mital
  • Bimlesh Kumar
  • Ajeet Yadav
  • Mohit Jain
  • Amit UpadhyayEmail author
Research Paper

Abstract

Objective

To compare the physical growth outcomes, morbidity profile and mortality at an age of 12 months among late preterm (340/7 to 366/7) neonates to term (370/7 to 416/7) neonates.

Study design

Prospective cohort study.

Setting

A tertiary care center of Northern India during 2014-2015.

Participants

200 apparently healthy late preterms and term infants, followed up to 12 months of age.

Main outcome measures

Physical growth parameters, morbidity profile and mortality.

Results

At mean age of 12 months, mean (SD) weight, length and head circumference of late preterms were 7.4 (0.8) kg, 69.2 (2.5) cm and 43.0 (1.1) cm, respectively; which were significantly lower than that of the full term infants [8.7 (1.6) kg, 72.2 (3.1) cm and 44.2 (1.1) cm] (P < 0.001). On univariate analysis, late preterm group was associated with higher odds (95% CI) of being underweight [5.6 (3.4, 5.5)], stunted [3.5 (2.1, 5.8)] and wasted [3.6 (1.9, 6.9)]. On multivariate analysis, only adjusted odds of late preterms becoming underweight by one year was significant [OR 4.1; 95% CI (1.6, 10.4)]. Feeding difficulties, jaundice and re-hospitalization rates were significantly higher in the late preterm group. The median (IQR) episodes per baby for late preterms as compared to terms for diarrhea [1.84 (0,3) vs 1.14 (0,2) (P <0.001)], and fever [1.33 (0,2) vs. 0.95 (0,2) (P = 0.01)] were higher.

Conclusion

Healthy late preterms are at significantly higher risk of being underweight in the first year of life, in addition to having significantly higher morbidity.

Keywords

Prematurity Prognosis Stunting Underweight Wasting 

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References

  1. 1.
    Teune MJ, Bakhuizen S, Gyamfi Bannerman C, Opmeer BC, van Kaam AH, van Wassenaer AG, et al. A systematic review of severe morbidity in infants born late preterm. Am J Obstet Gynecol. 2011;205:374.e1–9.CrossRefGoogle Scholar
  2. 2.
    Natarajan G, Shankaran S. Short-and long-term outcomes of moderate and late preterm infants. Am J Perinatol. 2016;33:305–17.CrossRefPubMedGoogle Scholar
  3. 3.
    Wang ML, Dorer DJ, Fleming MP, Catlin EA. Clinical outcomes of near-term infants. Pediatrics. 2004;114:372–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Boyle EM, Johnson S, Manktelow B, Seaton SE, Draper ES, Smith LK, et al. Neonatal outcomes and delivery of care for infants born late preterm or moderately preterm: A prospective population-based study. Arch Dis Child Fetal Neonatal Ed. 2015;100:F479–85.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Bird TM, Bronstein JM, Hall RW, Lowery CL, Nugent R, Mays GP. Late preterm infants: Birth outcomes and health care utilization in the first year. Pediatrics. 2010;126: e311–9.CrossRefPubMedGoogle Scholar
  6. 6.
    McLaurin KK, Hall CB, Jackson EA, Owens OV, Mahadevia PJ. Persistence of morbidity and cost differences between late-preterm and term infants during the first year of life. Pediatrics. 2009;123:653–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Dong Y, Yu JL. An overview of morbidity, mortality and long-term outcome of late preterm birth. World J Pediatr. 2011;7:199–204.CrossRefPubMedGoogle Scholar
  8. 8.
    Jaiswal A, Murki S, Gaddam P, Reddy A. Early neonatal morbidities in late preterm infants. Indian Pediatr. 2011;48:607–11.CrossRefPubMedGoogle Scholar
  9. 9.
    Committee on Obstetric Practice. Late-preterm infants. Obstet Gynecol. 2008;111:1029–32.CrossRefGoogle Scholar
  10. 10.
    Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991;119:417–23.CrossRefPubMedGoogle Scholar
  11. 11.
    Smith VC. The High Risk Newborn: Anticipation, Evaluation, Management and Outcome. In: Cloherty PJ, Eichenwald EC, Hansen AR, Stark AR, editors. Manual of Neonatal Care, 7thed, Wolters Kluwer (India) Pvt Ltd,2015.Google Scholar
  12. 12.
    Sharma R. Kuppuswamy’s socioeconomic status scalerevision for 2011 and formula for real-time updating. Indian J Pediatr. 2012;79;961–2.CrossRefPubMedGoogle Scholar
  13. 13.
    Definitions of indicators for child anthropometry -nlis_interpretation_guide.pdf. Available from: http://www.who.int/nutrition/nlis_interpretation_guide.pdf. Accessed September 18, 2016.Google Scholar
  14. 14.
    World Health Organization (WHO). The treatment of diarrhoea: a manual for physicians and other senior health workers -4th rev. WHO/COD/SER/80.2. Geneva: WHO; 2005. Available from: http://whqlibdoc.who.int/publi cations/2005/9241593180.pdf. Accessed March 29, 2014.Google Scholar
  15. 15.
    World Health Organization. Pocket Book of Hospital Care for Children: Guidelines for the Management of Common Illnesses with Limited Resources. Geneva, Switzerland: World Health Organization; 2005.Google Scholar
  16. 16.
    WHO The World Health Organization’s infant feeding recommendation. Available from: http://www.who.int/nutrition/topics/infantfeedingrecommendation/en/. Accessed October 4, 2015.Google Scholar
  17. 17.
    Santos IS, Matijasevich A, Domingues MR, Barros AJD, Victora CG, Barros FC. Late preterm birth is a risk factor for growth faltering in early childhood: A cohort study. BMC Pediatr. 2009;9:71CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Goyal NK, Fiks AG, Lorch SA. Persistence of underweight status among late preterm infants. Arch Pediatr Adolesc Med. 2012:166:424–30.CrossRefPubMedGoogle Scholar
  19. 19.
    Escobar GJ, Greene JD, Hulac P. Rehospitalisation after birth hospitalisation: patterns among infants of all gestations. Arch Dis Child. 2005;90:125–31.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Young PC, Korgenski K, Buchi KF. Early readmission of newborns in a large health care system. Pediatrics. 2013;131:e1538–44.CrossRefPubMedGoogle Scholar
  21. 21.
    Escobar GJ, Joffe S, Gardner MN, Armstrong MA, Folck BF, Carpenter DM. Rehospitalization in the first two weeks after discharge from the neonatal intensive care unit. Pediatrics. 1999;104:e2.CrossRefPubMedGoogle Scholar

Copyright information

© Indian Academy of Pediatrics 2017

Authors and Affiliations

  • Priyanka Gupta
    • 1
  • Ritu Mital
    • 1
  • Bimlesh Kumar
    • 1
  • Ajeet Yadav
    • 1
  • Mohit Jain
    • 1
  • Amit Upadhyay
    • 1
    Email author
  1. 1.Department of PediatricsLLRM Medical CollegeMeerutIndia

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