Maternal risk factors and early neonatal outcome among late preterm and term neonates in a neonatal intensive care unit in Punjab, India

Kambiakdik T., Anish D. Leelalanslat, Inderpreet Sohi, Varughese P. Varkey


Background: Late preterm neonates (34 to 36 weeks 6/7 days) were considered as ‘near term’ as they appeared apparently mature and comparable to term neonates. Many studies have now reported significantly higher rates of morbidity and mortality among this group of neonates. This study aims to evaluate the maternal risk factors associated with and short-term outcome of late preterm neonates compared to term neonates.

Methods: A Retrospective cohort study was conducted in the Neonatal Intensive Care Unit of a tertiary care teaching hospital. All intramural late preterm neonates with gestational age of 34-36 weeks born during the study period were enrolled. The control group included term neonates (37-42 weeks) born during the study period. Data regarding the maternal risk factors and neonatal outcomes for both the late preterm and term neonates were collected from records maintained in the NICU.

Results: There were 3275 deliveries during the study period, of which 2447 (74.8%) were term. Among the 828 preterm neonates, 500 (60.4%) were late preterms. The maternal risk factors significantly associated with late preterm neonates were PIH, eclampsia, APH, multiple gestation, PROM, oligohydramnios and abnormal dopplers. Incidence of Respiratory distress syndrome (RDS), sepsis and hypoglycemia were higher among the late preterm group with an odd’s ratio of 56.01, 9.9 and 7.8 respectively. Incidence of hypocalcemia, seizures and Persistent Pulmonary Hypertension (PPHN) were also higher among this group. There was no statistically significant difference in mortality among the two groups.

Conclusions: Late preterm neonates have a significantly higher neonatal morbidity compared to term neonates.


Late preterm, Maternal risk factors, Neonatal outcomes

Full Text:



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

Engle WA, Tomashek KM, Wallman C. Committee on Fetus and Newborn, American Academy of Pediatrics. "Late-preterm" infants: a population at risk. Pediatr. 2007;120:1390-401.

Davidoff M J, Dias T, Danus K. Changes in the gestational age distribution among U.S. Songleton births: impact on rates of late preterm birth; 1992 to 2002. Semin Perinatol. 2006;30:8-15.

Selvan T, Kumar P, Souza JLPD, Naresh, Swamy N, Anjan. A study of short term outcome of late preterm babies. Sch J App Med Sci. 2015;3:2190-4.

Kugelman A, Colin AA. Late preterm infants: near term but still in a critical development time period. Pediatr. 2013;132:741-9.

Loftin RW, Habli M, Snyder CC, Cormier CM, Lewis DF, Defranco EA. Late preterm birth. Rev Obstet Gynaecol. 2010;3:10-9.

Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, Barfield W, Nannini A, Weiss J, et al. Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk. Pediatr. 2008;121:e223-32.

McIntire DD, Leneno KJ. Neonatal mortality and morbidity rates in late preterm births compared with births at term. Obstet Gynecol. 2008;111:35-41.

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(2 Pt 1):253-60.

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

Raju TN, Higgins RD, Stark AR, Leveno KJ. Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development. Pediatr. 2006;118:1207-14.

Visruthan NK, Agarwal P, Sriram B, Rajadurai VS. Neonatal outcome of the late preterm (34 to 36 weeks): The Singapore story. Ann Acad Med Singapore. 2015;44:235-43.

Bulut C, Gursoy J, Ovali F. Short -term outcomes and mortality of late preterm infants. Balkan Med J. 2016;33:198-203.

Tsai ML, Lien R, Chiang MC, Hsu JF, Fu RH, Chu SM, et al. Prevalence and morbidity of late preterm infants: Current status in a medical center of Northern Taiwan. Pediatr Neonatol. 2012;53:171-7.

Haroon A, Ali SR, Ahmed S, Maheen H. Short term neonatal outcome in late preterm vs. term infants. J Coll Physicians Surg Pak. 2014;24:34-8.

Modi R, Modi B, Patel J. Comparison of neonatal morbidity and mortality among late preterm and term neonates at neonatal intensive care unit in Gujarat. Natl J Community Med. 2015;6:483-6.

Neogi SB, Zodpey S, Negandhi P, Gupta R. Use of sex selection techniques for social reasons: a menace. Indian Pediatr. 2017;54:99-101.

Tiwari SK, Kumar N, Kumar S, Prabha R. A study of late preterm babies for early neonatal outcome. Ind Jr Neo Med Res. 2017;5:1-5.