2381/31958
Elaine M. Boyle
Elaine M.
Boyle
Samantha Johnson
Samantha
Johnson
Bradley Manktelow
Bradley
Manktelow
Sarah E. Seaton
Sarah E.
Seaton
Elizabeth S. Draper
Elizabeth S.
Draper
Lucy K Smith
Lucy K
Smith
Jon Dorling
Jon
Dorling
N. Marlow
N.
Marlow
S. Petrou
S.
Petrou
D. J. Field
D. J.
Field
Neonatal outcomes and delivery of care for infants born late preterm or moderately preterm: A prospective population-based study
University of Leicester
2015
Prematurity
Late preterm
Moderately preterm
Neonatal outcomes
2015-04-08 09:58:09
Journal contribution
https://figshare.le.ac.uk/articles/journal_contribution/Neonatal_outcomes_and_delivery_of_care_for_infants_born_late_preterm_or_moderately_preterm_A_prospective_population-based_study/10139960
Objective: To describe neonatal outcomes and explore variation in delivery of care for infants born late (34-36 weeks) and moderately (32-33 weeks) preterm (LMPT).
Design/setting: Prospective population-based study comprising births in four major maternity centres, one midwifery-led unit and at home between September 2009 and December 2010. Data were obtained from maternal and neonatal records.
Participants: All LMPT infants were eligible. A random sample of term-born infants (≥37 weeks) acted as controls.
Outcome measures: Neonatal unit admission, respiratory and nutritional support, neonatal morbidities, investigations, length of stay and postnatal ward care were measured. Differences between centres were explored.
Results: 1146 (83%) LMPT and 1258 (79% of eligible) term-born infants were recruited. LMPT infants were significantly more likely to receive resuscitation at birth (17.5% v. 7.4%), respiratory (11.8% v. 0.9%) and nutritional support (3.5% v. 0.3%) and were less likely to be fed breast milk (64.2% v. 72.2%) than term infants. For all interventions and morbidities, a gradient of increasing risk with decreasing gestation was evident. Although 60% of late preterm infants were never admitted to a neonatal unit, 83% required medical input on postnatal wards. Clinical management differed significantly between services.
Conclusion: LMPT infants place high demands on specialist neonatal services. A substantial amount of previously unreported specialist input is provided in postnatal wards, beyond normal newborn care. Appropriate expertise and planning of early care
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is essential if such infants are managed away from specialised neonatal settings. Further research is required to clarify optimal and cost-effective postnatal management for LMPT babies.