Keywords
Enfermedades del prematuro
Hipoglucemia
Ictericia
Síndrome de dificultad respiratoria del recién nacido Infant
Premature
Diseases
Hypoglycemia
Jaundice
Respiratory distress syndrome
Newborn
How to Cite
Abstract
Introduction: Late preterm are those babies born between 34-36.6 weeks of gestational age. These babies present with significant physiological differences compared to term infants, which increases the risk of morbidity and mortality. Objective: To determine the prevalence of respiratory and metabolic complications of hospitalized late preterm infants in the newborn unit in the Clínica Universitaria Colombia between 2011-2014. Methodology: Retrospective observational study. Newborns between 34 and 36.6 weeks of gestational age admitted to Newborn Unit at Clínica Universitria Colombia from January 2011 to December 2014 were included. Maternal/fetal characteristics as well as respiratory and metabolic outcomes are described. Results: 12.037 births were registered at the Clínica Universitaria Colombia, of which 1.188 were late preterm (9.9%), 66.2% of the patients required intensive care surveillance, 26.1% mechanical ventilation, and 18.3% non-invasive ventilation. Respiratory complications were surfactant deficit disease (29.6%) and transient tachypnea (27.5%). 32.4% of patients were discharged with home oxygen indication. Most frequent metabolic complications were jaundice (32.4%) and hypoglycemia in (18.3%). Discussion: Late preterm present a high rate of short-term comorbidities, which should be evaluated by an interdisciplinary team including obstetricians, neonatologists, and pediatricians to assess possible risks, follow up and if necessary, early rehabilitation to avoid possible sequelae or long-term morbidity.
References
The Global Action Report on Preterm Birth [Internet]. World Health Organization. 2012. [Citada 9 febrero 2017] Disponible en http://www.who. int/pmnch/media/news/2012/201204_borntoosoon-report.pdf
Blencowe H., Cousens S., Oestergaard M., Chou D., Moller A., et al. National, regional and worldwide estimates of preterm birth rates in the year 2010 with time trends for selected countries since 1990: a systematic analysis and implications. Lancet 2012; 379: 2162-72 https://doi.org/10.1016/S0140-6736(12)60820-4
Khashu M, Narayanan M, Bhargava S, Osiovich H. Perinatal outcomes associated with preterm birth at 33 to 36 weeks' gestation: a populationbased cohort study. Pediatrics 2009 ;123(1):109-13. https://doi.org/10.1542/peds.2007-3743
Nandyal R, Sekar K. Late preterm infant - Nature's unfinished master piece. 2013;15(12).
Engle W a, Tomashek KM, Wallman C. "Late-preterm" infants: a population at risk. Pediatrics 2007;120(6):1390-401. https://doi.org/10.1542/peds.2007-2952
Raju T, Higgins R, Stark AR, Leveno K. Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development. Pediatrics. 2006;118(3):1207-14. https://doi.org/10.1542/peds.2006-0018
Gouyon J-B, Vintejoux A, Sagot P, Burguet A, Quantin C, Ferdynus C. Neonatal outcome associated with singleton birth at 34-41 weeks of gestation. Int J Epidemiol. 2010 Jun;39(3):769-76. https://doi.org/10.1093/ije/dyq037
McIntire, DD, Kenneth JL. "Neonatal mortality and morbidity rates in late preterm births compared with births at term." Obstetrics & Gynecology. 2008;111(1): 35-41. https://doi.org/10.1097/01.AOG.0000297311.33046.73
Boyle JD, Boyle EM. Born just a few weeks early: does it matter? Arch Dis Child Fetal Neonatal Ed 2013; 98: F85e8. https://doi.org/10.1136/archdischild-2011-300535
Field DJ, Kurinczuk JJ. Effects of gestational age at birth on health outcomes at 3 and 5 years of age : population based cohort study. 2012;896(March):1-14. https://doi.org/10.1136/bmj.e896
Hamilton B, Martin J, Ventura S. Births: Preliminary data for 2012. Natl Vital Stat Rep 2013;62(3):1-20.
Slattery M, Morrison J. Preterm delivery review. Lancet 2002; 360:1489-97 https://doi.org/10.1016/S0140-6736(02)11476-0
Hermansen CL, Lorah KN. Respiratory distress in the newborn. Am Fam Physician. 2007;76(7):987-994.
Clark RH. The epidemiology of respiratory failure in neonates born at an estimated gestational age of 34 weeks or more. J Perinatol. 2005;25:251-257 https://doi.org/10.1038/sj.jp.7211242
Fleming P., Arora P., Mitting R, Aladangady N. A National Survey of Admission Practices for Late Preterm Infants in England. BMC Pediatrics. 201414(1):150-154.
Escobar G, Claark R, Green J. Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions. Semin Perinatol. 2006;30:28-33 https://doi.org/10.1053/j.semperi.2006.01.005
Jain L, Eaton DC. Physiology of fetal lung fluid clearance and the effect of labor Semin Perinatol. 2006;30:34-43 https://doi.org/10.1053/j.semperi.2006.01.006
Pulver L, Denney J, Silver R, Young P. Morbidity and Discharge Timing of Late Preterm Newborns. Clinical Pediatrics. 2010;49:1061-7. https://doi.org/10.1177/0009922810376821
Engle W. Morbidity and Mortality in Late Preterm and Early Term Newborns: A Continuum. Clin Perinatol. 2011;38:493-516 https://doi.org/10.1016/j.clp.2011.06.009