Affiliations: Pediatrics, Harbor-UCLA Medical Center, David Geffen
School of Medicine at UCLA, Torrance, CA, USA
Note: [] Corresponding author: Virender K. Rehan, M.D, Pediatrics,
Harbor-UCLA Medical Center, 1124 W.Carson st, RB 1, Torrance, CA, 90502, USA.
Tel.: +1 310 222 1975; Fax: +1 310 222 3887; E-mail: vrehan@labiomed.org
Abstract: Late preterm births have been on the increase. Though the reasons
for the increase in late preterm births are unclear, non-medically indicated
inductions and cesarean sections seem to be the significant preventable
contributors. Late preterm infants are typically healthier than very preterm
infants, but compared to term infants they are at significantly increased risk
of both short and long term morbidity and mortality. In the short term they
have increased rates of feeding difficulties, hypoglycemia, jaundice,
temperature instability, apnea, respiratory distress and sepsis evaluation
compared to term infants. Emerging data also suggest a higher rate of long-term
neurodevelopmental, social, and medical morbidity. Therefore, if elective
induction of labor or cesarean section at late preterm gestation (34–36 weeks
of gestational age) is considered for either maternal or fetal indications, the
risk and benefits should be carefully examined. The family and physician should
discuss that elective delivery of late preterm infants is not recommended
unless absolutely indicated. Due to a considerably higher risk of morbidity and
mortality, developing and testing new paradigms of obstetric and fetal
management for pregnancies with potential for late preterm delivery are a
logical objective. For example, strategies to enhance fetal physiologic
maturation when late preterm delivery is unavoidable need to be explored.
Keywords: Late preterm infant, respiratory distress, thermoregulation, apnea, hyperbilirubinemia
