Late Preterm Infants Have Worse 24-Month Neurodevelopmental Outcomes Than Term Infants

Author:

Woythaler Melissa A.1,McCormick Marie C.23,Smith Vincent C.2

Affiliation:

1. Department of Neonatology, Massachusetts General Hospital, Boston, Massachusetts;

2. Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and

3. Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts

Abstract

BACKGROUND: Late preterm infants (34–37 weeks' gestation) are often perceived at similar risks for morbidity and mortality as term infants. OBJECTIVE: To compare the neurodevelopmental outcomes of late preterm to term infants. METHODS: Our study sample of 6300 term and 1200 late preterm infants came from the Early Childhood Longitudinal Study-Birth Cohort. We used general estimating equations to get weighted odds of having developmental delay, mental index scores (MDI) or psychomotor index scores (PDI) < 70, at 24 months of age. RESULTS: Late preterm infants compared with term infants had lower MDI (85 vs 89) and PDI (88 vs 92), both P < .0001, respectively. A higher proportion of late preterm infants compared with term infants had an MDI <70 (21% vs 16%; P < .0001). An equal number had PDIs <70 (6.1% vs 6.5%). After controlling for statistically significant and clinically relevant descriptive characteristics, late preterm infants still had higher odds of mental (odds ratio: 1.52 [95% confidence interval: 1.26–1.82] P < .0001) or physical (odds ratio: 1.56 [95% confidence interval: 1.30–1.89] P < .0001) developmental delay. CONCLUSIONS: Late preterm infants have poorer neurodevelopmental outcomes than term infants and have increased odds to have a mental and/or physical developmental delay.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

Reference43 articles.

1. National Center for Health Statistics. National vital statistics: births: final data 2006. Centers for Disease Control and Prevention. Available at: www.cdc.gov/nchs/nvss/birth_products.htm. Accessed May 26, 2009

2. The problem of late-preterm (near-term) births: a workshop summary;Raju;Pediatr Res,2006

3. Neurodevelopmental outcome of the late preterm infant;Adams-Chapman;Clin Perinatol,2006

4. The near-term (late preterm) human brain and risk for periventricular leukomalacia: a review;Kinney;Semin Perinatol,2006

5. Late gestation cerebellar growth is rapid and impeded by premature birth;Limperopoulos;Pediatrics,2005

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