612: Late preterm infants - a group with significant morbidity

SARAH CHENG, SANGEETA JAIN, KARIN A FOX, GEORGE R. SAADE, University of Texas Medical Branch, Division of Neonatology, Galveston, Texas, University of Texas Medical Branch, Pediatrics, Galveston, Texas, University of Texas Medical Branch, Obstetrics and Gynecology, Galveston, Texas OBJECTIVE: Late preterm infants (LPI) are infants born between 34 to 36w6d gestational age. The prevailing perception is that these infants do as well as term infants. Recent reports showed that they have greater respiratory distress (RD) and higher incidence of hyperbilirubinemia, feeding difficulties (FD), hypoglycemia, and temperature instability than term. Our aim was to evaluate the outcome of LPI stratified by gestational age. STUDY DESIGN: We reviewed records (n 201) of LPI born at the University of Texas Medical Branch. Infants with congenital anomaly or neuromuscular disease were excluded from study. Detailed pregnancy and maternal demographic data were collected. The incidence of RD, jaundice, hypoglycemia & FD was compared. Data was analyzed using Chi square test for RDS, FD and jaundice(significance: p 0.05) and ANOVA for hospital stay. RESULTS: The LPI constituted 9% of all deliveries, 35w4d as average gestational age at delivery. Overall incidence of RD requiring oxygen with nasal cannula/ NCPAP was 22%, jaundice requiring phototherapy was 46%, FD requiring gavage feed was 22%, and hypoglycemia was 15%. The average hospital stay was 171 hours. Morbidity stratified by gestational age is shown in table (* shows significant difference). CONCLUSION: LPI need to be recognized as a separate group of infants associated with greater morbidity than the term infants. Revised protocols need to be instituted in the nurseries in managing these infants. Long term follow up is needed to study their neurodevelopmental outcome.