Advertisement

127: Late preterm births infants: A serious national public health problem

      Objective

      “Late preterm birth infants” have higher risks for mortality and morbidity compared with term infants. The objective of this study is to compare pregnancy outcomes and neonatal morbidity between infants born between 34-36 weeks (LPTB) to 37-42 weeks (TERM) of gestation using 2004 CDC national birth registry

      Study Design

      A secondary analysis was performed using data from the 2004 National Center for Health Statistics natality birth computerized statistical files .Data is processed per state and then submitted to the National Center for Health Statistics, who later publishes the data .Data have been coded according to uniform coding specifications, have passed rigid quality control standards, have been edited and reviewed and are the basis for official US births statistics. Data was stratified into two groups; I. LPTB (34-36 6/7 weeks) and II. TERM (37-42 weeks). Maternal demographics and pregnancy complications were analyzed. Neonatal variables included the following;rates of Respiratory Distress syndrome(RDS), 5 min APGAR score < 7, assisted ventilation and neonatal seizures. A composite neonatal morbidity consisted of one or more of the above complications

      Results

      A total of 213,565 LPTB occurred in 2004 in the US. Women in the LPTB group had higher rates of hypertension, preeclampsia and preterm premature rupture of membranes when compared to women in the TERM group. The neonatal composite morbidity was significantly higher in late PTB group than in the term group (8.9 % vs. 3.3%, p < 0.001). Infants in the LPTB were more likely to have RDS, (AOR 5.3, 95th CI 5.0-5.5), assisted ventilation (AOR 3.7, 95th CI 3.6-3.9) and 5 min Apgar score < 7 (AOR 1.6, 95th 1.5-1.7).

      Conclusion

      Neonatal morbidity is significantly higher among infants among LPTB, particularly RDS.Increased awareness of LPTB among obstetricians and new strategies for its reduction must be a priority.