DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20172660

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

Manish Rasania, Prasad Muley

Abstract


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. 


Keywords


Immediate outcome, Late preterm, Morbidities, Term infants

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References


Committee on obstetric practice. ACOG committee opinion no. 404 April 2008. Late preterm infants. Obstet Gynecol. 2008;111(4):1029-32.

Engle WA, Tomashek KM, Wallman C. Committee on fetus and newborn, Americal Aademy of Pediatrics. “Late preterm” infants: a population at risk. Pediatrics. 2007;120(6):1390-1401.

Kugelman A, Colin AA. Late preterm infants: near term but still in a critical developmental time period. Pediatrics. 2013;132(4):741-51.

Wang ML, Dorer DJ, Fleming MP, Catlin EA. Clinical outcomes of near term infants. Pediatrics. 2004;114:372-6.

Melamed N, Klinger G, Tenenbaum-Gavish K, Herscovici T, Linder N, Hod M, et al. Short term neonatal outcome in low risk, spontaneous singleton late preterm deliveries. Obstet Gynecol. 2009;114:253-60.

Jaiswal A, Murki S, Gaddam P and Reddy A. Early neonatal morbidities in late preterm infants. Indian Pedaitrics. 2011;48:607-11.

Araujo BF, Zatti H, Madi JM, Coelho MB, Olmi FB, Canabarro CT. Analysis of neonatal morbidity and mortality in late preterm newborn infants. J Paediatr Rio J. 2012;88(3):259-66.

Mally PV, Hendricks-Munoz KD, Bailey S. Incidence and etiology of late preterm admissions to the neonatal intensive care unit and its associated respiratory morbidities when compared to term infants. Am J Perinatol. 2013;30(5):425-31.

Gilbert WM, Nesbitt TS, Danielsen B. The cost of prematurity: quantification by gestational age and birth weight. Obstet Gynaecol. 2003;102:488-92

Machado LC, Passini R, Rosa IR, Carvalho HB. Neonatal outcomes of late preterm and early term birth. Eur J Obstetr Gynecol Reproduct Biol. 2014; 179:204-8.

Ghulam Nabi Rather, Muzafar Jan, Wasim Rafiq, Imran Gatoo, Sheikh Quyoom Hussain, Mohmad Latief. Morbidity and mortality pattern in late preterm infants as a tertiary care hospital hospital in Jammu and Kashmir, Northern India. J Clinic Diagnos Res. 2015;9(12):SC01-SC04.