Authors: Diana Simão-Raimundo, Augusta Arruda, Mariana Ormonde, Sarah Stokreef, Catarina Dâmaso, Ana Furtado-Lima.
Introduction: Late preterm infants (LPT) are at high risk for perinatal acute morbidity and mortality. This risk seems to be lower with increasing gestational age (GA). We aim to discuss if an individual approach to the LPT according to GA is justified.
Materials and Methods: A secondary analysis of a retrospective study on antenatal corticosteroids in LPT birth was performed. Singleton, nonanomalous, delivered at 34–36 weeks infants born between January 1 2012, and December 31 2017 were included and classified into three groups according to GA at birth: 34+0 to 34+6 weeks; 35+0 to 35+6; 36+0 to 36+6. Primary outcomes included neonatal morbidity at birth and neonatal respiratory morbidity in the first 72 hours. Maternal demographic and obstetric data were analyzed as possible confounders.
Results: From a total of 390 LPT, 58.4% were born at 36 weeks, 24.9% at 35 and 16.7% at 34. Respiratory morbidity was 7 times higher in 34w than in 36w neonates. Comparing with 36w, 34w neonates reported 2.6 times more jaundice and 9 times more NICU admission. Neonates born at 34 weeks were more likely to present, with statistical significance: need of oxygen supplementation at birth and in the first 72 hours of life; need for non-invasive respiratory support; RDS of newborn; TTN; NICU admission; prolonged hospital stay for more than seven days; need for nutrition through nasogastric tube; jaundice with need for phototherapy; sepsis evaluation; treatment with antibiotics; hypoglycemia. Respiratory and non-respiratory outcomes decreased with increasing GA.
Discussion: These findings suggest that one week makes a difference in neonatal outcomes. Whenever possible efforts should be made to postpone preterm delivery. A discussion about individual approach to LPT according to GA should be raised. GA-specific guidelines could be justified to anticipate and prevent morbidity in perinatal life.
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