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113: Neonatal and developmental outcomes in children born in the late preterm period versus term

      Objective

      Neonatal outcomes are poorer for late preterm (LP) (34′0 to 36′6 wks) compared with term infants. The brain undergoes significant maturation during the LP period, suggesting long term neuro-developmental outcomes may be affected. We evaluated differences in morbidity at birth and indicators of potential developmental delay for infants born at 34, 35, or 36 completed weeks, compared with infants born at ≥39 weeks, using the Ages and Stages Questionnaire (ASQ), a screening tool validated against the Bayley and McCarthy Scales that identifies children needing further evaluation.

      Study Design

      LP children of participants in a randomized placebo-controlled trial of 17 OHPC to prevent recurrent preterm delivery were compared with 39' week children from the same study; congenital malformations were excluded. Follow-up occured at a subset of the participating centers. If a child scored <2 SD below population-derived means on 1 or more of 5 domains, the ASQ was considered abnormal. ASQ and height/weight percentiles were evaluated between groups. Composite neonatal morbidities (respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, hyperbilirubinemia, sepsis, ventilator support, or death) were also evaluated.

      Results

      287 neonates were included; 145 were followed up at a median age of 48 months (range 32-64). Neonatal morbidity decreased with increasing gestational age (p<0.0001). There were no differences in ASQ performance. Height/weight percentiles were also similar. Adjusting for treatment group and race yielded similar results.

      Conclusion

      Despite increased neonatal morbidity, ASQ scores and height/weight are similar between children born in the LP period and those born at 39' weeks. While reassuring, this finding warrants validation with a larger sample size and diagnostic testing.
      Table 1
      ASQ AbnormalMorbidity
      34 WKS3/15 (20.0%)10/30 (33.3%)
      35 WKS2/14 (14.3%)4/38 (10.5%)
      36 WKS8/35 (22.9%)5/62 (8.1%)
      39+ WKS22/81 (27.2%)3/157 (1.9%)
      Total35/145 (24.1%)22/287 (7.7%)
      P-value0.8160<0.0001