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Late preterm infant: risks and follow-up
Also known as Late preterm infant: risks and follow-up
Fellowship guide to late preterm infant: risks and follow-up.
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Overview & Definition
Picture the 35-week baby on the postnatal ward — plump, pink, eyes open, breastfeeding by the clock — the very picture of a healthy newborn. Within twenty-four hours the bilirubin is climbing, the glucose is dipping, the temperature is drifting down and the mother is exhausted. This is the late-preterm paradox: a baby who looks term and behaves preterm. Recognising that paradox is the single most important cognitive step in caring for this group, and it is the question examiners return to again and again. [1] [2]
A late-preterm infant is defined by gestational age at birth of 34+0 to 36+6 completed weeks. The group is sometimes called "near-term" or "moderate-late preterm", but the term late-preterm is now preferred because "near-term" falsely implies maturity — it invites exactly the complacency that causes harm. Late-preterm infants are the largest preterm subgroup by absolute number, accounting for roughly seventy per cent of all preterm births and around nine per cent of all live births in high-income settings. [1] [6]
Late preterm is distinct from early term (37+0 to 38+6), which the Defining Term Pregnancy Workgroup carved out as its own higher-risk band within term, and from moderately preterm (32+0 to 33+6). These distinctions are not pedantry — each week closer to full term reduces risk, but the late-preterm band remains a high-risk population whose care and follow-up must be planned, not assumed. [6]
References11ShowHide
- [1]Engle WA, Tomashek KM, Wallman C Late-preterm infants: a population at risk Pediatrics, 2007.PMID 18055691
- [2]Raju TN The problem of late-preterm (near-term) births: a workshop summary Pediatr Res, 2006.PMID 17065577
- [3]McIntire DD, Leveno KJ Neonatal mortality and morbidity rates in late preterm births compared with births at term Obstet Gynecol, 2008.PMID 18165390
- [4]Teune MJ, Bakhuizen S, Gyamfi Bannerman C, et al. A systematic review of severe morbidity in infants born late preterm Am J Obstet Gynecol, 2011.PMID 21864824
- [5]Kuzniewicz MW, Parker SJ, Schnake-Mahl A, Escobar GJ Hospital readmissions and emergency department visits in moderate preterm, late preterm, and early term infants Clin Perinatol, 2013.PMID 24182960
- [6]Spong CY Defining term pregnancy: recommendations from the Defining Term Pregnancy Workgroup JAMA, 2013.PMID 23645117
- [7]Gyamfi-Bannerman C, Thom EA, Blackwell SC, et al. Antenatal Betamethasone for Women at Risk for Late Preterm Delivery N Engl J Med, 2016.PMID 26842679
- [8]Fenton TR, Kim JH A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants BMC Pediatr, 2013.PMID 23601190
- [9]WHO Multicentre Growth Reference Study Group WHO Child Growth Standards based on length/height, weight and age Acta Paediatr Suppl, 2006.PMID 16817681
- [10]Bhutani VK, Stark AR, Lazzeroni LC, Poland R, Gourley GR Predischarge screening for severe neonatal hyperbilirubinemia identifies infants who need phototherapy J Pediatr, 2013.PMID 23043681
- [11]Huff K, Rose RS, Engle WA Late Preterm Infants: Morbidities, Mortality, and Management Recommendations Pediatr Clin North Am, 2019.PMID 30819344