PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

Case Study

Volume 3 Issue 3

Clinical Profile of Late Preterm Neonates Admitted to a Tertiary Care NICU

Dinesh Kumar Vuppu and Venugopal Reddy Iragamreddy*

August 18, 2023

DOI : 10.56831/PSMPH-03-083

View PDF

Abstract

Introduction: In a study conducted at tertiary care center, Bangalore, a total of 144 late preterm neonates were studied. The majority of the neonates were born with a birth weight of more than 2 kg, and the study found that 28.33% of late preterm infants developed one or more complications leading to a hospital stay of more than 7 days. Most of the neonates required intravenous infusions, antibiotics, and were subjected to investigations for sepsis. In a study by Shapiro Mendoza et al, 22.8% of late preterms experienced at least one complication that could lead to prolonged hospital stay.

Methods: Late preterm infants are at high risk for neonatal morbidities, including neonatal hyperbilirubinemia requiring phototherapy, respiratory distress, sepsis, and feed intolerance. The duration of hospital stay was prolonged in late preterm neonates, with most requiring more than 7 days hospital duration. The rate of rehospitalization was also high.

Discussion: The study highlights the need for further studies to establish and evaluate strategies, routines, and protocols for premature interruption of pregnancy, reducing the number of premature births and developing obstetric protocols that increase the precision of methods for estimating gestational age (GA). Additionally, the study suggests using antenatal corticosteroid after 34 weeks to reduce respiratory pathologies and prevent a significant number of deaths in this group of neonates.

Conclusion: In conclusion, late preterm infants are at high risk for neonatal morbidities, including neonatal hyperbilirubinemia requiring phototherapy, respiratory morbidity, mechanical ventilation, sepsis, and hypoglycemia. Prolonging pregnancy to the maximum safest gestation can result in a decrease in these morbidities.

References

  1. American Academy of Pediatrics, Committee on Fetus Newborn. “Levels of neonatal care”. Pediatrics 114 (2012): 587-97.
  2. Raju TNK., et al. “Optimizing care and outcome for late preterm (near-term) infants: a summary of the workshop sponsored by the NICHD”. Pediatrics 118 (2006): 1207-14.
  3. Davidoff MJ., et al. “Changes in the gestational age distribution among US singleton births: impact on rates of late preterm birth, 1992 to 2002”. Semin Perinatol 30 (2006): 8-15.
  4. Mateus J., et al. “Preterm premature rupture of membranes: clinical outcomes of late-preterm infants”. Clin Pediatr (Phila) 49 (2010): 60-65.
  5. Buus-Frank ME. “The great imposter”. Adv Neonatal Care 5.5 (2005): 233-6.
  6. Ashish Jaiswal., et al. “Early Neonatal Morbidities in Late Preterm Infants”. Indian Pediatr 48 (2011): 607-611.
  7. Gabriel J et al. “Short-Term Outcomes of Infants Born at 35 and 36 Weeks Gestation: We Need to Ask More Questions”. Affiliations Division of Research, Perinatal Research Unit, Kaiser Permanente Medical Care Program, Oakland, CA. Seminars in Perinatology 30 (2006): 28-33.
  8. Teune MJ., et al. “A systemic review of severe morbidity in infants born late preterm”. Am J Obstet Gynecol 205 (2011): 374.e1-9.
  9. Xiaolu Ma., et al. “The clinical outcomes of late preterm infants: a multicenter survey of Zhejiang, China”. J. Perinat. Med 39 (2009): 695-699.
  10. Osama Abu-Salah. “Unfavourable outcomes associated with late preterm birth: observations from Jordan”. JPMA 61 (2011): 769-72.
  11. Raju TN., et al. “Optimizing care and outcome for late-preterm (near-term) gestations and for late-preterm infants: a summary of the workshop sponsored by the National Institutes of Health and Human Development”. Pediatrics 118 (2006): 1207-1214.
  12. Kramer MS., et al. “The contribution of mild and moderate preterm birth to infant mortality. Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System”. JAMA 284 (2000): 843-849.
  13. Meharban Singh. “Care of the Newborn”. 7th edition. Sagar publications (2010): 234-235.
  14. Shapiro-Mendoza CK., et al. “Risk factors for neonatal morbidity and mortality among “healthy” late preterm newborns”. Semin Perinatol 30 (2006): 54-60.
  15. Reddy UM., et al. “Delivery indications at late-preterm gestations and infant mortality rates in the United States”. Pediatrics 124 (2009): 234-240.
  16. Laughon SK., et al. “Precursors for late preterm birth in singleton gestations”. Obstet Gynecol 116.5 (2010): 1047-55.
  17. William A Engle and Michelle A Kominiarek. “Late Preterm Infants, Early Term Infants, and Timing of Elective Deliveries”. Clin Perinatol 35 (2008): 325-341.
  18. The American College of Obstetricians and Gynecologists. ACOG Practice Bulletin. Management of preterm labour. Clinical management guidelines for Obstetrician-Gynecologists. No 43, Obstet Gynecol 101 (2003): 1039-47.
  19. Barros FC and Valez Mdel P. “Temporal trends of preterm birth subtypes and neonatal outcomes”. Obstet Gynecol 107 (2006): 1035-41.
  20. Committee on Obstetric Practice. ACOG Committee Opinion No. 404 April 2008. Late-preterm infants. Obstet Gynecol 111 (2008): 1029-32.
  21. William A Engle, Kay M Tomashek and Carol Wallman. ''Late-Preterm'' Infants: A Population at Risk”. American Academic of Pediatrics 120 (2007): 1390-401.
  22. Cloherty John P., et al. “Manual of Neonatal Care”. 6th Edition. Lippincott (2012): 323-330.