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NeonatologyNeonatology

Section I. Basic Management > 

Chapter 17. Management of the Late Preterm Infant

Topics Discussed: Growth and Development; infant, premature; premature birth.
Excerpt:"Introduction. The increased number of infants who deliver between 34 and 37 weeks is a vexing problem for pediatric and obstetric practitioners alike. It has been the subject of growing interest and concern that has generated new research into the causation as well as the appropriate management of these patients.
The most agreed-on definition of late preterm infants are those born between 34 0/7 and 36 6/7 weeks' gestation. Older literature refers to these infants as "near term," suggesting they are equivalent to term infants. Recently, the consensus is to refer to these infants as "late preterm," which conveys an appropriate sense of their vulnerability.
Between 1992 and 2002, late preterms increased from 7.3–8.5% of all births, a 16% increase. They now represent about three quarters of all preterm births. Davidoff demonstrated the median gestational age at delivery for singletons born in the United States is now 39 weeks. Another study showed that infants born at 34 weeks were 4.6 times more likely to die than those at 40 weeks, which contributes significantly to the neonatal mortality rate.
Potential etiologies. Although the exact causation of increased late preterm delivery remains elusive, the rate must be rising due to increased medical interventions at or beyond 34 weeks.
  1. Preeclampsia is the most common complication..."
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