Early neonatal outcome in late preterms compared with term neonates

Abstract

Introduction: Neonates born between 34 weeks and 36 weeks 6 days of gestational age (GA) are known as late preterm neonates. These late preterm neonates are the largest subgroup of preterm neonates. There have been few studies regarding the early morbidity in this cohort of neonates when compared to neonates born at term. Objectives: The objectives of the study were to study the incidence and various causes of early morbidities and mortality in late preterm neonates and to compare with term neonates. Materials and Methods: This prospective cohort study was conducted at a tertiary care teaching institution of Bengaluru. All late preterm and term neonates born between December 2016 and July 2018 were enrolled in the study. Data regarding parity, mode of delivery, sex, GA, birth weight, predefined neonatal morbidities, and maternal risk factors were all entered in the pre-designed pro forma. The morbidities and mortality of these late preterm neonates were compared with the term neonates. Results: A total of 408 late preterms and 1660 term neonates were enrolled in this study. These late preterm neonates were at significantly higher risk of overall morbidity due to any cause (85.3%, p<0.001, adjusted odds ratio [OR]: 1.4, 95% confident interval [CI]=0.8–2.4). They were also at higher risk of developing respiratory distress (23.5%, p<0.001, adjusted OR: 1.5, 95% CI: 1.1–2.2), need for ventilation ([Nasal continuous positive airway pressure – 8.6%] [synchronized intermittent mandatory ventilation [SIMV] – 3.7%], p<0.001), and neonatal sepsis (9.1%, p=0.003, adjusted OR: 1.3, 95% CI=0.3–3.3) when compared with term neonates. Conclusion: Gestational maturity is the most important determinant of the outcome in newborns. Late preterm neonates are not the same as term neonates as evidenced by the high incidence of complications in late preterm compared to term infants.