N-D Outcome in Near-term Babies

Chyi L, Lee H, Hintz S, et al. School Outcomes of Late Preterm Infants: Special Needs and Challenges for Infants Born at 32 to 36 Weeks Gestation. J Pediatr, (July 2008) 153: 25-31. Full Text | Full-Text PDF (118 KB)

Objective. Because limited long-term outcome data exist for infants born at 32 to 36 weeks gestation, we compared school outcomes between 32- to 33-week moderate preterm (MP), 34-36 week late preterm (LP) and full-term (FT) infants.

Study design: A total of 970 preterm infants and 13,671 FT control subjects were identified from the Early Childhood Longitudinal Study-Kindergarten Cohort. Test scores, teacher evaluations, and special education enrollment from kindergarten (K) to grade 5 were compared.

Results. LP infants had lower reading scores than FT infants in K to first grade (P < .05). Adjusted risk for poor reading and math scores remained elevated in first grade (P < .05). Teacher evaluations of math skills from K to first grade and reading skills from K to fifth grade were worse for LP infants (P < .05). Adjusted odds for below average skills remained higher for math in K and for reading at all grades (P < .05). Special education participation was higher for LP infants at early grades (odds ratio, 1.4-2.1). MP infants had lower test and teacher evaluation scores than FT infants and twice the risk for special education at all grade levels.

Conclusions. Persistent teacher concerns through grade 5 and greater special education needs among MP and LP infants suggest a need to start follow-up, anticipatory guidance, and interventions for infants born at 32 to 36 weeks gestation.

School Outcome in Late Preterm Infants: A Cause for Concern; J Pediatr Volume 153, Issue 1, Pages 5-6 (July 2008) by Lucky Jain .
Full Text | PDF (115 KB)

Comments: In recent years the short term morbidity associated with late preterm infant have been of great concern, particularly in relation to late preterm cesarean section deliveries. It is well known that there is a considerable risk for the poor developmental outcomes for very preterm infants. However, the majority of infants born preterm are between 32 and 36 weeks gestation. Most of these infants have few acute problems and are discharged from nurseries presumed healthy. In the above article the authors provide us with school age outcomes to grade 5 for infants born at 32-36 weeks gestation. The late pretermers had lower math and reading skills and more need for special education than did comparison full-term infants. These late preterm infants represent over 10% of all deliveries in the US and are generally called normal, but they are not. DB

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