Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 1207-1214 (doi:10.1542/peds.2006-0018)
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SPECIAL ARTICLE

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

Tonse N.K. Raju, MDa, Rosemary D. Higgins, MDa, Ann R. Stark, MDb and Kenneth J. Leveno, MDc

a National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
b Division of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
c Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas

In 2003, 12.3% of births in the United States were preterm (<37 completed weeks of gestation). This represents a 31% increase in the preterm birth rate since 1981. The largest contribution to this increase was from births between 34 and 36 completed weeks of gestation (often called the "near term" but referred to as "late preterm" in this article). Compared with term infants, late-preterm infants have higher frequencies of respiratory distress, temperature instability, hypoglycemia, kernicterus, apnea, seizures, and feeding problems, as well as higher rates of rehospitalization. However, the magnitude of these morbidities at the national level and their public health impact have not been well studied. To address these issues, the National Institute of Child Health and Human Development of the National Institutes of Health invited a multidisciplinary team of experts to a workshop in July 2005 entitled "Optimizing Care and Outcome of the Near-Term Pregnancy and the Near-Term Newborn Infant." The participants discussed the definition and terminology, epidemiology, etiology, biology of maturation, clinical care, surveillance, and public health aspects of late-preterm infants. Knowledge gaps were identified, and research priorities were listed. This article provides a summary of the meeting.


Key Words: prematurity • low birth weight • preterm birth • near-term infant • late-preterm infant • seizures • kernicterus • respiratory distress syndrome • apnea • sudden infant death

Abbreviations: TTN—transient tachypnea of the newborn • RDS—respiratory distress syndrome


Accepted Mar 31, 2006.




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