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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.|
Seaton, Sarah E.
Draper, Elizabeth S.
Smith, Lucy K
Field, D. J.
|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.|
|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: http://creativecommons.org/licenses/by-nc/4.0/|
|Appears in Collections:||Published Articles, Dept. of Health Sciences|
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|Arch Dis Child Fetal Neonatal Ed-2015-Boyle-archdischild-2014-307347.pdf||Publisher version||358.1 kB||Adobe PDF||View/Open|
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