DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20150530

Clinical profile and early hospital outcome of late preterms admitted in a tertiary care neonatal unit from South India

Ezhilvannan NR, Vani HN, Niranjan HS, Naveen Benakappa

Abstract


Background: Late preterm infants refer to those born between 34 completed weeks (340/7) and less than 37 completed weeks (366/7). The incidence of medical problems, either short-term or long-term, is higher among late preterm infants than term infants.

Methods: This is prospective observational study conducted in Indira Gandhi Institute of Child Health, which is a tertiary care pediatric hospital, which caters to only outborn. All late preterm babies admitted, who met the inclusion criteria were studied for a period of one year from September 2012 to august 2013. After taking consent from parents, detailed antenatal history were taken in a structured proforma. Short term outcome was assessed in the form of neonatal morbidities, mortality. These late preterm infants were followed up and readmission to hospital and reasons for readmission were evaluated. 

Results: A total of one hundred and forty four late preterm neonates comprised the study group. Male preponderance was noticed with a ratio of 1.5:1. Majority of the neonates had birth weight more than 2 kg. Premature rupture of membrane and previous history of caesarian section formed the major maternal risk factor for preterm. Neonatal hyperbilirubinemia was the major morbidity followed by respiratory distress, sepsis and feed intolerance. Majority of late preterm neonates required more than 7 days of hospital stay. Rate of rehospitalisation were also high among late preterm.

Conclusions: Late preterm infant group is less studied group. Morbidity and mortality in them is higher than expected, hence they need special attention while in hospital and a better follow up protocol after discharge. Late preterm infants comprise the majority of preterm newborns, caring for such a large population who are prone to have unfavourable outcomes can exert a profound impact on the society. 


Keywords


Late preterm, Hyperbilirubinemia, Sepsis

Full Text:

PDF

References


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

Engle WA, Tomashek KM, Wallman C. “Late-preterm” infants: a population at risk. Am Acad Pediatr. 2007;120:1390.

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

Khashu M, Narayanan M, Bhargava S, Osiovich H. Perinatal outcomes associated with preterm birth at 33 to 36 weeks gestation: a population based cohort study. Pediatrics. 2009;123:109-13

Escobar GJ, Clark RH, Greene JD. Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions. Semin Perinatol. 2006;30:28-33.

Teune MJ, Bakhuizen S, Gyamfi Bannerman C, Opmeer BC, van Kaam AH, van Wassenaer AG, et al. A systemic review of severe morbidity in infants born late preterm. Am J Obstet Gynecol. 2011;205:374.e1-9.

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

Engle WA, Michelle A. Kominiarek. Late preterm infants, early term infants, and timing of elective deliveries. Clin Perinatol. 2008;35:325-41.

Gouyon BJ, Vintejoux A, Sagot P, Burguet A, Quantin C, Ferdynus C. Neonatal outcome associated with singleton birth at 34-41 weeks of gestation. Int J Epidemiol. 2010;39:769-76.

Reddy UM, Ko CW, Raju TN, Willinger M. Delivery indications at late-preterm gestations and infant mortality rates in the United States. Pediatrics. 2009;124(1):234-40.

Laughon SK, Reddy UM, Sun L, Zhang J. Precursors for late preterm birth in singleton gestations. Obstet Gynecol. 2010;116(5):1047-55.

Leone A, Ersfeld MP, Adams M, Schiffer M, Bucher HU, Arlettaz R. Neonatal morbidity in singleton late preterm infants compared with fullterm infants. Acta Paediatrica. 2012;101(1):e6-10.

Haroon A, Ali SR, Ahmed S, Maheen H. Short term outcome in late preterm vs. term infants. J Coll Physicians Surg Pak. 2014;24(1):34-8.

Osama Abu-Salah. Unfavourable outcomes associated with late preterm birth: observations from Jordan. JPMA. 2011;61:769.

Young PC, Glasgow TS, Xi LI, Warnick GG, Stoddard GJ. Mortality of late preterm newborns in Utah. Pediatrics. 2007;119:659-65.

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;30:61-8.

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