Melissa Lorenzo MD Pediatric medical resident

Immaturity Plays Leading Role in Late Preterm Complications Interview with:

Melissa Lorenzo MD Pediatric medical resident

Dr. Lorenzo

Melissa Lorenzo MD
Pediatric medical resident
Dr. Lorenzo is currently training at the University of Toronto, however the research was conducted while a medical student at Queens University What is the background for this study?

Response: Preterm infants are born before 37 weeks gestation, with late preterm neonates defined as infants born between 34 weeks to 37 weeks gestation. Of all preterm births, over 70% of babies are born in the late preterm period. Late preterm births are common, affecting 12.5% of all births in the United States.

Compared to infants born at term, late preterm neonates are at increased risk for many common complications following birth such as jaundice, low blood sugar, and respiratory distress, prolong hospital stay, admission to the neonatal intensive care unit, and increase readmission rate after hospital discharge. There are many causes for preterm delivery- two important ones are early onset of labour either spontaneous or after premature rupture of membranes, and medically indicated delivery prior to full term gestation due to chronic diseases in mother affecting her health in pregnancy, fetal medical reasons, or placental insufficiency. There is a debate that the risk of neonatal complications is affected by the causes of preterm delivery with immaturity acting as a contributing factor. The relative contribution of immaturity versus the reason for delivery and the resulting neonatal complications is unclear. What are the main findings?

Response: Our study examined if complications in late preterm neonates is related to the reasons of early birth. We divided causes of preterm birth into three most common categories i.e medically indicated reasons, preterm premature rupture of membranes, and threated preterm labor. The neonatal complications studied in our cohort included respiratory distress, jaundice, low blood sugar, and requirement for respiratory support (CPAP).

We found that younger neonates were significantly more likely to suffer complications (babies born at 34 weeks more likely to suffer complications then those at 35 or 36 weeks). However, we found no significant difference in complications due to the different causes of premature delivery. What should readers take away from your report?

Response: Our study suggests that immaturity, rather than the causes of preterm delivery, plays a leading role in late preterm infant complications. What recommendations do you have for future research as a result of this work? 

Response: With further knowledge of late preterm delivery and the complications that these infants may face given the different causes of preterm delivery, health care providers could potentially predict and then provide targeted treatments directed at reducing or eliminating infant morbidity.

Disclosure:  We have no disclosures.


Morbidity Risk Among Late Term Preterm Infants: Immaturity vs Indication of Delivery,
Pediatric Academic Societies 2018 abstract May 2018

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