Postnatal Hospitalization Rates and Short-Term Follow-up Results of Late Preterm, Early Term, and Term Newborns

Abstract

Objective: Late preterm newborns are defined as infants born at 34-36 weeks of gestation, while early term newborns are those born at 37-38 weeks. Late preterm and early term newborns have higher risks of morbidity and mortality compared to term infants. The aim of this study was to investigate the causes of neonatal morbidity and mortality in late preterm and early term newborns with reference to term newborns. Materials and Methods: A total of 1000 newborns born between 34 and 42 weeks of gestation in our hospital were included in this study. These cases were evaluated according to maternal age, birth weight, APGAR score, mode of delivery, need for postnatal resuscitation, family income, hospitalization rate, and need for mechanical ventilation. Results: Among the 1000 newborns included in the study, respiratory problems were more common in male newborns. As income levels increased, the rate of births closer to term increased. The hospitalization rate of late preterm newborns was higher compared to early term and term newborns while APGAR scores were lower. Finally, the need for mechanical ventilation was higher among late preterm newborns. Conclusion: In evaluations of late preterm and early term newborns, their physiological immaturity should be considered and it should not be forgotten that they have higher risks in terms of morbidity and mortality. Delivery should not be planned before the 39th week of gestation unless there is a medical indication.

Keywords

• Late Preterm
• Early Term
• Morbidity

References

1. Obstetricians ACo, Gynecologists. ACOG Committee Opinion No 579: definition of term pregnancy. Obstet Gynecol. 2013; 122(5):1139-40.
2. Obstetricians ACo, Gynecologists. ACOG committee opinion no. 561: Nonmedically indicated early-term deliveries. Obstet Gynecol. 2013; 121(4):911-15.
3. Kliegman R, Stoll B. The High-Risk Infant. In: Kliegman R, Behrman R, St. Geme J, Schor N, Stanton B, editors. Nelson Textbook of Pediatrics. 19 ed. W.B. Saunders Company: Philadelphia; 2011.
4. Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, Barfield W, Weiss J, Evans S, editors. Risk factors for neonatal morbidity and mortality among "healthy," late preterm newborns. Seminars in perinatology; 2006: Elsevier.
5. Gcyener K, Kazanc� E. Ge￧ Preterm ve Erken Term Bebeklerin N￶rolojik ￝zlemi. Turk Klinik J Pediatric Sci. 2014; 10(4):35-42.
6. Bastek JA, Sammel MD, Par￩ E, Srinivas SK, Posencheg MA, Elovitz MA. Adverse neonatal outcomes: examining the risks between preterm, late preterm, and term infants. Am J Obstet Gynecol. 2008; 199(4):367.
7. Cheng YW, Nicholson JM, Nakagawa S, Bruckner TA, Washington AE, Caughey AB. Perinatal outcomes in low-risk term pregnancies: do they differ by week of gestation? Am J Obstet Gynecol. 2008; 47(4):330-33.
8. Gouyon J-B, Vintejoux A, Sagot P, Burguet A, Quantin C, Ferdynus C, et al. Neonatal outcome associated with singleton birth at 34-41 weeks of gestation. Int J Epidemiol. 2010; 39(3):769-76.

9. Hibbard JU, Wilkins I, Sun L, Gregory K, Haberman S, Hoffman M, et al. Respiratory morbidity in late preterm births. JAMA. 2010;304(4):419.
10. 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, Part 1):253-60.
11. Lindstr￶m K, Lindblad F, Hjern A. Psychiatric morbidity in adolescents and young adults born preterm: a Swedish national cohort study. Pediatrics. 2009;123(1):e47-e53.
12. Davidoff MJ, Dias T, Damus K, Russell R, Bettegowda VR, Dolan S, et al. editors. Changes in the gestational age distribution among US singleton births: impact on rates of late preterm birth, 1992 to 2002. Seminars in perinatology; 2006: Elsevier.
13. Tomashek KM, Shapiro-Mendoza CK, Davidoff MJ, Petrini JR. Differences in mortality between late-preterm and term singleton infants in the United States, 1995-2002. J Pediatr. 2007; 151(5):450-56.
14. Young PC, Glasgow TS, Li X, Guest-Warnick G, Stoddard G. Mortality of late-preterm (near-term) newborns in Utah. Pediatrics. 2007; 119(3):e659-e65.
15. 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(1):109-13.
16. Ananth CV, Friedman AM, Gyamfi-Bannerman C. Epidemiology of moderate preterm, late preterm and early term delivery. Clin Perinatol. 2013; 40(4):601-10.
17. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S, et al. Births: final data for 2005. NVSR. 2007;56(6):1-103.
18. Morse SB, Zheng H, Tang Y, Roth J. Early school-age outcomes of late preterm infants. Pediatrics. 2009; 123(4):e622-e9.
19. Wang ML, Dorer DJ, Fleming MP, Catlin EA. Clinical outcomes of near-term infants. Pediatrics. 2004; 114(2):372-76.
20. Woythaler MA, McCormick MC, Smith VC. Late preterm infants have worse 24-month neurodevelopmental outcomes than term infants. Pediatrics. 2011; 127(3):e622-e9.
21. Bulut O, Buyukkayhan D. Early term delivery is associated with increased neonatal respiratory morbidity. Pediatr Int. 2021; 63(1):60-64.
22. Thomas J, Olukade TO, Naz A, Salama H, Al-Qubaisi M, Al Rifai H, et al. The neonatal respiratory morbidity associated with early term caesarean section - an emerging pandemic. J Perinat Med. 2021; 49(7):767-72.
23. Kallapur S, Jobe A. Lung development and maturation. Fanaroff and Martin's Neonatal Perinatal Medicine Philadelphia, PA: Elsevier Saunders. 2015:1042-59.
24. Tita AT, Landon MB, Spong CY, Lai Y, Leveno KJ, Varner MW, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes. New Eng J Med. 2009; 360(2):111-20.
25. Ghartey K, Coletta J, Lizarraga L, Murphy E, Ananth CV, Gyamfi-Bannerman C. Neonatal respiratory morbidity in the early term delivery. Am J Obstet Gynecol. 2012; 207(4):292.
26. Cond￲ V, Cipriani S, Colnaghi M et al. Neonatal respiratory distress syndrome: are risk factors the same in preterm and term infants? J Matern-Fetal Neonatal Med. 2017; 30(11):1267-72.
27. Provost PR, Simard M, Tremblay Y. A link between lung androgen metabolism and the emergence of mature epithelial type II cells. Am J Respir Crit Care Med. 2004; 170:296-305.
28. Atasay B, Okulu E, Ak�n ￝M, ￇand�r O, Arsan S, Trmen T. Ge￧ prematre yenido￰anlar�n erken klinik sonu￧lar�. Trkiye ￇocuk Hastal�klar� Derg. 2010; 4(1):30-35.
29. De Carolis MP, Pinna G, Cocca C, Rubortone SA, Romagnoli C, Bersani I, et al. The transition from intra to extra-uterine life in late preterm infant: a single-center study. Ital J Pediatr. 2016; 42(1):1-7.
30. Rabinovich A, Tsemach T, Novack L, Mazor M, Rafaeli-Yehudai T, Staretz-Chacham O, et al. Late preterm and early term: when to induce a growth restricted fetus? A population-based study. J Matern-Fetal Neonatal Med. 2018; 31(7):926-32.
31. Engle WA, Kominiarek MA. Late preterm infants, early term infants, and timing of elective deliveries. Clin Perinatol. 2008;35(2):325-41.
32. Nkansah-Amankra S, Luchok KJ, Hussey JR, Watkins K, Liu X. Effects of maternal stress on low birth weight and preterm birth outcomes across neighborhoods of South Carolina, 2000-2003. JMCH. 2010; 14(2):215-26.
33. Ruth CA, Roos N, Hildes-Ripstein E, Brownell M. The influence of gestational age and socioeconomic status on neonatal outcomes in late preterm and early term gestation: a population based study. BMC Pregnancy Childbirth. 2012; 12(1):1-8.
34. Engle WA. Morbidity and mortality in late preterm and early term newborns: a continuum. Clin Perinatol.2011; 38(3):493-516.
35. King JP, Gazmararian JA, Shapiro-Mendoza CK. Disparities in mortality rates among US infants born late preterm or early term, 2003-2005. Matern Child Health J. 2014; 18(1):233-41.
36. Engle WA, Tomashek KM, Wallman C. "Late-preterm" infants: a population at risk. Pediatrics. 2007; 120(6):1390-401.