Health Risks Associated With Late-Preterm Infants
Health Risks Associated With Late-Preterm Infants
This integrative literature review focuses on the health risks associated with late-preterm infants (34 to 36 and 6/7 weeks gestation) and the implications for newborn primary care providers and pediatric nurses. Common morbidities in the late-term population included hyperbilirubinemia, respiratory compromise, hyperglycemia and poor feeding, temperature instability, and infection. Primary care providers should be aware of these morbidities to be sure risk-focused evaluation is performed during and after the birth hospitalization, and treatment is administered when necessary.
Seventy-one percent of all preterm infants in 2009 were considered late-preterm (i.e., infants born between 34 and 36 and 6/7-week gestation (Martin et al., 2011). Late-preterm infants may approximate weight of term infants and may initially transition well from birth; however, they may fail to maintain this stability (Kelly, 2010). Until recently, parents, caregivers, and health professionals have treated late-preterm infants the same as term infants, yet they are physiologically and metabolically immature and have a high risk of newborn morbidity (Engle, Tomashek, Wallman, & the Committee on Fetus and Newborn, 2007; Raju, Higgins, Stark, & Leveno, 2006). Several studies have found that the late-preterm population is at risk for respiratory complications, hyperbilirubinemia, poor feeding and hypoglycemia, temperature instability, and infection. These are all issues that can lead to admission to the NICU and a prolonged stay in the hospital, and the earlier the gestation, the higher the risk (Bastek, Sammel, Rebele, Srinivas, & Elovitz, 2010; Consortium on Safe Labor et al., 2010; Dani et al., 2009; Lubow, How, Habli, Maxwell, & Sibai, 2009; Mally, Bailey, & Hendricks-Munoz, 2010; McIntire & Leveno, 2008; Melamed et al., 2009; Pulver, Denney, Silver, & Young 2010; Raju et al., 2006; Shapiro-Mendoza et al., 2008; Tomashek et al., 2006; Vachharajani & Dawson, 2009; Wang, Dorer, Fleming, & Catlin, 2004). Primary care providers must recognize the inherent risks associated with late-preterm births to identify risk-focused management strategies for primary care of this population.
Abstract and Introduction
Abstract
This integrative literature review focuses on the health risks associated with late-preterm infants (34 to 36 and 6/7 weeks gestation) and the implications for newborn primary care providers and pediatric nurses. Common morbidities in the late-term population included hyperbilirubinemia, respiratory compromise, hyperglycemia and poor feeding, temperature instability, and infection. Primary care providers should be aware of these morbidities to be sure risk-focused evaluation is performed during and after the birth hospitalization, and treatment is administered when necessary.
Introduction
Seventy-one percent of all preterm infants in 2009 were considered late-preterm (i.e., infants born between 34 and 36 and 6/7-week gestation (Martin et al., 2011). Late-preterm infants may approximate weight of term infants and may initially transition well from birth; however, they may fail to maintain this stability (Kelly, 2010). Until recently, parents, caregivers, and health professionals have treated late-preterm infants the same as term infants, yet they are physiologically and metabolically immature and have a high risk of newborn morbidity (Engle, Tomashek, Wallman, & the Committee on Fetus and Newborn, 2007; Raju, Higgins, Stark, & Leveno, 2006). Several studies have found that the late-preterm population is at risk for respiratory complications, hyperbilirubinemia, poor feeding and hypoglycemia, temperature instability, and infection. These are all issues that can lead to admission to the NICU and a prolonged stay in the hospital, and the earlier the gestation, the higher the risk (Bastek, Sammel, Rebele, Srinivas, & Elovitz, 2010; Consortium on Safe Labor et al., 2010; Dani et al., 2009; Lubow, How, Habli, Maxwell, & Sibai, 2009; Mally, Bailey, & Hendricks-Munoz, 2010; McIntire & Leveno, 2008; Melamed et al., 2009; Pulver, Denney, Silver, & Young 2010; Raju et al., 2006; Shapiro-Mendoza et al., 2008; Tomashek et al., 2006; Vachharajani & Dawson, 2009; Wang, Dorer, Fleming, & Catlin, 2004). Primary care providers must recognize the inherent risks associated with late-preterm births to identify risk-focused management strategies for primary care of this population.
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