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Title: Neonatal outcomes and delivery of care for infants born late preterm or moderately preterm: A prospective population-based study
Authors: Boyle, Elaine M.
Johnson, Samantha
Manktelow, Bradley
Seaton, Sarah E.
Draper, Elizabeth S.
Smith, Lucy K
Dorling, Jon
Marlow, N.
Petrou, S.
Field, D. J.
First Published: 1-Apr-2015
Publisher: BMJ Publishing Group
Citation: Archives of Disease in Childhood: Fetal and Neonatal Edition 1 April 2015;0:F1–F7
Abstract: Objective: To describe neonatal outcomes and explore variation in delivery of care for infants born late (34-36 weeks) and moderately (32-33 weeks) preterm (LMPT). Design/setting: Prospective population-based study comprising births in four major maternity centres, one midwifery-led unit and at home between September 2009 and December 2010. Data were obtained from maternal and neonatal records. Participants: All LMPT infants were eligible. A random sample of term-born infants (≥37 weeks) acted as controls. Outcome measures: Neonatal unit admission, respiratory and nutritional support, neonatal morbidities, investigations, length of stay and postnatal ward care were measured. Differences between centres were explored. Results: 1146 (83%) LMPT and 1258 (79% of eligible) term-born infants were recruited. LMPT infants were significantly more likely to receive resuscitation at birth (17.5% v. 7.4%), respiratory (11.8% v. 0.9%) and nutritional support (3.5% v. 0.3%) and were less likely to be fed breast milk (64.2% v. 72.2%) than term infants. For all interventions and morbidities, a gradient of increasing risk with decreasing gestation was evident. Although 60% of late preterm infants were never admitted to a neonatal unit, 83% required medical input on postnatal wards. Clinical management differed significantly between services. Conclusion: LMPT infants place high demands on specialist neonatal services. A substantial amount of previously unreported specialist input is provided in postnatal wards, beyond normal newborn care. Appropriate expertise and planning of early care 5 is essential if such infants are managed away from specialised neonatal settings. Further research is required to clarify optimal and cost-effective postnatal management for LMPT babies.
DOI Link: 10.1136/archdischild-2014-307347
ISSN: 1359-2998
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Appears in Collections:Published Articles, Dept. of Health Sciences

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