Clinical Outcomes of Near-Term Infants
* Neonatology Unit, Pediatric Service, MassGeneral Hospital for Children, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
Biostatistics Unit, Massachusetts General Hospital, Boston, Massachusetts
Service Line Analysis, Partners HealthCare, Boston, Massachusetts
Objective. To test the hypothesis that near-term infants have more medical problems after birth than full-term infants and that hospital stays might be prolonged and costs increased.
Methods. Electronic medical record database sorting was conducted of 7474 neonatal records and subset analyses of near-term (n = 120) and full-term (n = 125) neonatal records. Cost information was accessed. Length of hospital stay, Apgar scores, clinical diagnoses (temperature instability, jaundice, hypoglycemia, suspicion of sepsis, apnea and bradycardia, respiratory distress), treatment with an intravenous infusion, delay in discharge to home, and hospital costs were assessed.
Results. Data from 90 near-term and 95 full-term infants were analyzed. Median length of stay was similar for near-term and full-term infants, but wide variations in hospital stay were documented for near-term infants after both vaginal and cesarean deliveries. Near-term and full-term infants had comparable 1- and 5-minute Apgar scores. Nearly all clinical outcomes analyzed differed significantly between near-term and full-term neonates: temperature instability, hypoglycemia, respiratory distress, and jaundice. Near-term infants were evaluated for possible sepsis more frequently than full-term infants (36.7% vs 12.6%; odds ratio: 3.97) and more often received intravenous infusions. Cost analysis revealed a relative increase in total costs for near-term infants of 2.93 (mean) and 1.39 (median), resulting in a cost difference of $2630 (mean) and $429 (median) per near-term infant.
Conclusions. Near-term infants had significantly more medical problems and increased hospital costs compared with contemporaneous full-term infants. Near-term infants may represent an unrecognized at-risk neonatal population.
Key Words: neonate • outcome • prematurity • near term • costs • newborn
Abbreviations: OR, odds ratio • CI, confidence interval • FE, Fisher exact test • TTN, transient tachypnea of the newborn
Received for publication Apr 4, 2003; Accepted Dec 22, 2003.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  J. Mateus, K. Fox, S. Jain, S. Jain, R. Latta, and J. Cohen Preterm Premature Rupture of Membranes: Clinical Outcomes of Late-Preterm Infants Clinical Pediatrics, January 1, 2010; 49(1): 60 - 65. [Abstract] [PDF]
|
|
|
|
|
|
R. Kitsommart, M. Janes, V. Mahajan, A. Rahman, W. Seidlitz, J. Wilson, and B. Paes Outcomes of Late-Preterm Infants: A Retrospective, Single-Center, Canadian Study Clinical Pediatrics, October 1, 2009; 48(8): 844 - 850. [Abstract] [PDF]
|
|
|
|
 |
|
 A. L. van Baar, J. Vermaas, E. Knots, M. J. K. de Kleine, and P. Soons Functioning at School Age of Moderately Preterm Children Born at 32 to 36 Weeks' Gestational Age Pediatrics, July 1, 2009; 124(1): 251 - 257. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. A. Engle Infants Born Late Preterm: Definition, Physiologic and Metabolic Immaturity, and Outcomes NeoReviews, June 1, 2009; 10(6): e280 - e286. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. S. Pulver, G. Guest-Warnick, G. J. Stoddard, C. L. Byington, and P. C. Young Weight for Gestational Age Affects the Mortality of Late Preterm Infants Pediatrics, June 1, 2009; 123(6): e1072 - e1077. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Vachharajani and J. G. Dawson Short-Term Outcomes of Late Preterms: An Institutional Experience Clinical Pediatrics, May 1, 2009; 48(4): 383 - 388. [Abstract] [PDF]
|
|
|
|
 |
|
 Y. Nomura, J. M. Halperin, J. H. Newcorn, C. Davey, W. P. Fifer, D. A. Savitz, and J. Brooks-Gunn The Risk for Impaired Learning-related Abilities in Childhood and Educational Attainment Among Adults Born Near-term J. Pediatr. Psychol., May 1, 2009; 34(4): 406 - 418. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. B. Morse, H. Zheng, Y. Tang, and J. Roth Early School-Age Outcomes of Late Preterm Infants Pediatrics, April 1, 2009; 123(4): e622 - e629. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Kalia, P. Visintainer, H. L. Brumberg, M. Pici, and J. Kase Comparison of Enrollment in Interventional Therapies Between Late-Preterm and Very Preterm Infants at 12 Months' Corrected Age Pediatrics, March 1, 2009; 123(3): 804 - 809. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. K. McLaurin, C. B. Hall, E. A. Jackson, O. V. Owens, and P. J. Mahadevia Persistence of Morbidity and Cost Differences Between Late-Preterm and Term Infants During the First Year of Life Pediatrics, February 1, 2009; 123(2): 653 - 659. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Khashu, M. Narayanan, S. Bhargava, and H. Osiovich Perinatal Outcomes Associated With Preterm Birth at 33 to 36 Weeks' Gestation: A Population-Based Cohort Study Pediatrics, January 1, 2009; 123(1): 109 - 113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. C. McCormick, G. J. Escobar, Z. Zheng, and D. K. Richardson Factors Influencing Parental Satisfaction With Neonatal Intensive Care Among the Families of Moderately Premature Infants Pediatrics, June 1, 2008; 121(6): 1111 - 1118. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Burgos, S. K. Schmitt, D. K. Stevenson, and C. S. Phibbs Readmission for Neonatal Jaundice in California, 1991-2000: Trends and Implications Pediatrics, April 1, 2008; 121(4): e864 - e869. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. N.K. Raju Late-Preterm Births: Challenges and Opportunities Pediatrics, February 1, 2008; 121(2): 402 - 403. [Full Text] [PDF]
|
|
|
|
|
|
C. K. Shapiro-Mendoza, K. M. Tomashek, M. Kotelchuck, W. Barfield, A. Nannini, J. Weiss, and E. Declercq Effect of Late-Preterm Birth and Maternal Medical Conditions on Newborn Morbidity Risk Pediatrics, February 1, 2008; 121(2): e223 - e232. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. A. Engle, K. M. Tomashek, C. Wallman, and and the Committee on Fetus and Newborn "Late-Preterm" Infants: A Population at Risk Pediatrics, December 1, 2007; 120(6): 1390 - 1401. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. B. Russell, N. S. Green, C. A. Steiner, S. Meikle, J. L. Howse, K. Poschman, T. Dias, L. Potetz, M. J. Davidoff, K. Damus, et al. Cost of Hospitalization for Preterm and Low Birth Weight Infants in the United States Pediatrics, July 1, 2007; 120(1): e1 - e9. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. C. Young, T. S. Glasgow, X. Li, G. Guest-Warnick, and G. Stoddard Mortality of Late-Preterm (Near-Term) Newborns in Utah Pediatrics, March 1, 2007; 119(3): e659 - e665. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. N.K. Raju, R. D. Higgins, A. R. Stark, and K. J. Leveno 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, September 1, 2006; 118(3): 1207 - 1214. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. K. Stein, M. J. Siegel, and L. J. Bauman Are Children of Moderately Low Birth Weight at Increased Risk for Poor Health? A New Look at an Old Question Pediatrics, July 1, 2006; 118(1): 217 - 223. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G J Escobar, M C McCormick, J A F Zupancic, K Coleman-Phox, M A Armstrong, J D Greene, E C Eichenwald, and D K Richardson Unstudied infants: outcomes of moderately premature infants in the neonatal intensive care unit Arch. Dis. Child. Fetal Neonatal Ed., July 1, 2006; 91(4): F238 - F244. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. A. Mathews, B. Bimson, T. L. Lowe, L. D. Herrera, C. L. Budman, G. Erenberg, A. Naarden, R. D. Bruun, N. B. Freimer, and V. I. Reus Association Between Maternal Smoking and Increased Symptom Severity in Tourette's Syndrome Am J Psychiatry, June 1, 2006; 163(6): 1066 - 1073. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Stellwagen and E. Boies Care of the Well Newborn Pediatr. Rev., March 1, 2006; 27(3): 89 - 98. [Full Text] [PDF]
|
|
