Impact of late preterm and early term infants on Canadian neonatal intensive care units

Am J Perinatol. 2014 Apr;31(4):269-78. doi: 10.1055/s-0033-1347364. Epub 2013 May 31.

Abstract

Objective: To examine the short-term morbidities, mortality, and use of neonatal intensive care unit (NICU) resources for late preterm, early term, and term infants.

Study design: Infants born between 34 and 40 weeks of gestation and admitted to a Canadian NICU in 2010 were designated late preterm (340/7 to 366/7 weeks), early term (370/7 to 386/7 weeks), or term (390/7 to 406/7 weeks). Mortality, short-term morbidities, and resource utilization were compared between the three groups using chi-square tests and analysis of variance.

Results: Among 6,636 included infants, 44.2% (n = 2,935) were late preterm, 26.2% (n = 1,737) early term, and 29.6% (n = 1,964) term. Term infants were more likely to require resuscitation at birth and had lower Apgar scores than late preterm and early term infants (p < 0.001). Length of stay and need for respiratory support decreased with increasing gestational age; however, the proportion of hospital days that intensive care was required increased.

Conclusion: The greatest impact of late preterm infants is on NICU bed occupancy, whereas for term infants it is on intensity of care. Early term infants experience greater rates of some complications than term, demonstrating that risk persists for these infants. These findings have important implications for NICU resource planning and practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bed Occupancy / statistics & numerical data*
  • Canada
  • Cohort Studies
  • Female
  • Gestational Age*
  • Health Resources / statistics & numerical data
  • Humans
  • Infant
  • Infant Mortality
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / mortality
  • Infant, Premature, Diseases / therapy
  • Intensive Care Units, Neonatal / statistics & numerical data*
  • Length of Stay / statistics & numerical data*
  • Male
  • Respiration, Artificial / statistics & numerical data
  • Respiratory Distress Syndrome, Newborn / mortality
  • Respiratory Distress Syndrome, Newborn / therapy*