A prospective study comparing the morbidities of                                 late preterm and term infants in the neonatal period in a tertiary care hospital

Sirajuddin Nazeer; Sivagurunathan Panchanathan; Karthikeyan Soundararajan

doi:10.18203/2349-3291.ijcp20211666

Authors

Sirajuddin Nazeer Department of Pediatrics, KAPV Government Medical College, Trichy, Tamil Nadu, India
Sivagurunathan Panchanathan Department of Pediatrics, KAPV Government Medical College, Trichy, Tamil Nadu, India
Karthikeyan Soundararajan Department of Pediatrics, KAPV Government Medical College, Trichy, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20211666

Keywords:

Late preterm, Term, Incidence, Morbidity

Abstract

Background: In obstetric practice, 34 completed weeks is considered as maturational milestone for the fetus. Despite relatively large size and apparent functional maturity, late preterm infants are at increased risk for neonatal morbidity compared with full term infants. Aim of the study was to study the incidence of late preterm births in a tertiary care hospital in Trichy, Tamil Nadu and to study the pattern of neonatal morbidities in late preterm infants and to compare it with term infants.

Methods: Hospital based prospective study was conducted from April 2019 to March 2020. Total 470 late preterm infants were included in our study. All infants enrolled in the study were followed up daily till discharge and after discharge, all infants were than reviewed at 15 and 28 days in a well-baby clinic.

Results: There were a total of 1941 live births during the study period. Of these, 470 (24.2%) were late preterm and 1263 (65%) were term births. Late preterm infants accounted for 71.1% of preterm birth. Late preterm infants were at significantly higher risk for overall morbidity due to any cause, respiratory 22.1%, neonatal jaundice 62%, sepsis 4%, hypoglycemia 8.9%, hospital readmission 8.1%. 63% of late preterm infants were readmitted for jaundice.

Conclusions: The incidence of late preterm birth was 24%. Late preterm infants had a higher incidence of jaundice, sepsis and respiratory morbidities. Late preterm infants had a longer hospital stay. They were also more likely to get readmitted in the hospital when compared to term infants.

Metrics

Metrics Loading ...

References

Engle WA, Kominiarek MA. Late preterm infants, early term infants, and timing of elective deliveries. Clin in Perinatol. 2008;35(2):325-41.

Engle WA. A recommendation for the definition of late preterm (near-term) and the birth weight gestational age classification system. Semin Perinatol. 2006;30(1):2-7.

Raju TNK, 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. Pediatrics. 2006;118(3):1207-14.

Raju TNK. Late-preterm births: challenges and opportunities. Pediatrics. 2008;121(2):402-3.

Teune MJ, Bakhuizen S, Bannerman CG, Opmeer BC, Kaam AHV, Wassenier AGV, et al. A systematic review of severe morbidity in infants born late preterm. Am J Obstet Gynecol. 2011;205(4):374.

Dong Y, Yu J. An overview of morbidity, mortality and long-term outcome of late preterm birth. World J Pediat. 2011;7(3):199-204.

Kumar A, Bhatnagar V. Respiratory distress in neonates. Ind J Pediat. 2005;72(5):425-8.

Sankar MJ, Agarwal R, Deorari AK, Paul VK. Sepsis in the newborn. Ind J Pediat. 2008;75(3):261-6.

Davidoff MJ, Dias T, Damus K, Russell R, Bettegowda BR, Dolan S, et al. Changes in the gestational age distribution among US singleton births: impact on rates of late preterm birth, 1992 to 2002. Semin Perinatol. 2006;30(1):8-15.

McIntire DD, Leveno KJ. Neonatal mortality and morbidity rates in late preterm births compared with births at term. Obstet Gynecol. 2008;111(1):35-41.

Ramachandrappa A, Jain L. Health issues of the late preterm infant. Pediatric Clin North Am. 2009;56(3):565-77.

Raju TNK. Epidemiology of late preterm (near-term) births. Clin Perinatol. 2006;33(4):751-63.

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. Pediatrics. 2008;121(2):223-32.

Gilbert WM, Nesbitt TS, Danielsen B. The cost of prematurity: quantification by gestational age and birth weight. Obstet Gynecol. 2003;102(3):488-92.

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

McIntire DD, Leveno KJ. Neonatal mortality and morbidity rates in late preterm births compared with births at term. Obstet Gynecol. 2008;111(1):35-41.

Escobar GJ, Greene JD, Hulac P, Kincannon E, Bischoff K, Gardner M, et al. Rehospitalisation after birth hospitalisation: patterns among infants of all gestations. Arch Dis Child. 2005;90(2):125-31.

Tomashek KM, Shapiro-Mendoza CK, Weiss J, Kotelchuck M, Barfield W, Evans S, et al. Early discharge among late preterm and term newborns and risk of neonatal morbidity. Semin Perinatol. 2006;30(2):61-8.