Abstract
Context: Late preterm births (34 0/7-36 6/7 weeks) account for an increasing proportion of prematurity-associated short-term morbidities, particularly respiratory, that require specialized care and prolonged neonatal hospital stays. Objective: To assess short-term respiratory morbidity in late preterm births compared with term births in a contemporary cohort of deliveries in the United States. Design, Setting, and Participants: Retrospective collection of electronic data from 12 institutions (19 hospitals) across the United States on 233 844 deliveries between 2002 and 2008. Charts were abstracted for all neonates with respiratory compromise admitted to a neonatal intensive care unit (NICU), and late preterm births were compared with term births in regard to resuscitation, respiratory support, and respiratory diagnoses. A multivariate logistic regression analysis compared infants at each gestational week, controlling for factors that influence respiratory outcomes. Main Outcome Measures: Respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, respiratory failure, and standard and oscillatory ventilator support. Results: Of 19 334 late preterm births, 7055 (36.5%) were admitted to a NICU and 2032 had respiratory compromise. Of 165 993 term infants, 11 980 (7.2%) were admitted to a NICU, 1874 with respiratory morbidity. The incidence of respiratory distress syndrome was 10.5% (390/3700) for infants born at 34 weeks' gestation vs 0.3% (140/41 764) at 38 weeks. Similarly, incidence of transient tachypnea of the newborn was 6.4%(n=236) for those born at 34 weeks vs 0.4% (n=155) at 38 weeks, pneumonia was 1.5% (n=55) vs 0.1% (n=62), and respiratory failure was 1.6% (n=61) vs 0.2% (n=63). Standard and oscillatory ventilator support had similar patterns. Odds of respiratory distress syndrome decreased with each advancing week of gestation until 38 weeks compared with 39 to 40 weeks (adjusted odds ratio [OR] at 34 weeks, 40.1; 95% confidence interval [CI], 32.0-50.3 and at 38 weeks, 1.1; 95% CI, 0.9-1.4). At 37 weeks, odds of respiratory distress syndrome were greater than at 39 to 40 weeks (adjusted OR, 3.1; 95% CI, 2.5-3.7), but the odds at 38 weeks did not differ from 39 to 40 weeks. Similar patterns were noted for transient tachypnea of the newborn (adjusted OR at 34 weeks, 14.7; 95% CI, 11.7-18.4 and at 38 weeks, 1.0; 95% CI, 0.8-1.2), pneumonia (adjusted OR at 34 weeks, 7.6; 95% CI, 5.2-11.2 and at 38 weeks, 0.9; 95% CI, 0.6-1.2), and respiratory failure (adjusted OR at 34 weeks, 10.5; 95% CI, 6.9-16.1 and at 38 weeks, 1.4; 95% CI, 1.0-1.9). Conclusion: In a contemporary cohort, late preterm birth, compared with term delivery, was associated with increased risk of respiratory distress syndrome and other respiratory morbidity.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 419-425 |
| Number of pages | 7 |
| Journal | JAMA - Journal of the American Medical Association |
| Volume | 304 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jul 28 2010 |
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ASJC Scopus subject areas
- Medicine(all)
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Respiratory morbidity in late preterm births. / Hibbard, Judith U.; Wilkins, Isabelle; Sun, Liping; Gregory, Kimberly; Haberman, Shoshana; Hoffman, Matthew; Kominiarek, Michelle A.; Reddy, Uma; Bailit, Jennifer; Branch, D. Ware; Burkman, Ronald; Quintero, Victor Hugo Gonzalez; Hatjis, Christos G.; Landy, Helain; Ramirez, Mildred; VanVeldhuisen, Paul; Troendle, James; Zhang, Jun.
In: JAMA - Journal of the American Medical Association, Vol. 304, No. 4, 28.07.2010, p. 419-425.Research output: Contribution to journal › Article
TY - JOUR
T1 - Respiratory morbidity in late preterm births
AU - Hibbard, Judith U.
AU - Wilkins, Isabelle
AU - Sun, Liping
AU - Gregory, Kimberly
AU - Haberman, Shoshana
AU - Hoffman, Matthew
AU - Kominiarek, Michelle A.
AU - Reddy, Uma
AU - Bailit, Jennifer
AU - Branch, D. Ware
AU - Burkman, Ronald
AU - Quintero, Victor Hugo Gonzalez
AU - Hatjis, Christos G.
AU - Landy, Helain
AU - Ramirez, Mildred
AU - VanVeldhuisen, Paul
AU - Troendle, James
AU - Zhang, Jun
PY - 2010/7/28
Y1 - 2010/7/28
N2 - Context: Late preterm births (34 0/7-36 6/7 weeks) account for an increasing proportion of prematurity-associated short-term morbidities, particularly respiratory, that require specialized care and prolonged neonatal hospital stays. Objective: To assess short-term respiratory morbidity in late preterm births compared with term births in a contemporary cohort of deliveries in the United States. Design, Setting, and Participants: Retrospective collection of electronic data from 12 institutions (19 hospitals) across the United States on 233 844 deliveries between 2002 and 2008. Charts were abstracted for all neonates with respiratory compromise admitted to a neonatal intensive care unit (NICU), and late preterm births were compared with term births in regard to resuscitation, respiratory support, and respiratory diagnoses. A multivariate logistic regression analysis compared infants at each gestational week, controlling for factors that influence respiratory outcomes. Main Outcome Measures: Respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, respiratory failure, and standard and oscillatory ventilator support. Results: Of 19 334 late preterm births, 7055 (36.5%) were admitted to a NICU and 2032 had respiratory compromise. Of 165 993 term infants, 11 980 (7.2%) were admitted to a NICU, 1874 with respiratory morbidity. The incidence of respiratory distress syndrome was 10.5% (390/3700) for infants born at 34 weeks' gestation vs 0.3% (140/41 764) at 38 weeks. Similarly, incidence of transient tachypnea of the newborn was 6.4%(n=236) for those born at 34 weeks vs 0.4% (n=155) at 38 weeks, pneumonia was 1.5% (n=55) vs 0.1% (n=62), and respiratory failure was 1.6% (n=61) vs 0.2% (n=63). Standard and oscillatory ventilator support had similar patterns. Odds of respiratory distress syndrome decreased with each advancing week of gestation until 38 weeks compared with 39 to 40 weeks (adjusted odds ratio [OR] at 34 weeks, 40.1; 95% confidence interval [CI], 32.0-50.3 and at 38 weeks, 1.1; 95% CI, 0.9-1.4). At 37 weeks, odds of respiratory distress syndrome were greater than at 39 to 40 weeks (adjusted OR, 3.1; 95% CI, 2.5-3.7), but the odds at 38 weeks did not differ from 39 to 40 weeks. Similar patterns were noted for transient tachypnea of the newborn (adjusted OR at 34 weeks, 14.7; 95% CI, 11.7-18.4 and at 38 weeks, 1.0; 95% CI, 0.8-1.2), pneumonia (adjusted OR at 34 weeks, 7.6; 95% CI, 5.2-11.2 and at 38 weeks, 0.9; 95% CI, 0.6-1.2), and respiratory failure (adjusted OR at 34 weeks, 10.5; 95% CI, 6.9-16.1 and at 38 weeks, 1.4; 95% CI, 1.0-1.9). Conclusion: In a contemporary cohort, late preterm birth, compared with term delivery, was associated with increased risk of respiratory distress syndrome and other respiratory morbidity.
AB - Context: Late preterm births (34 0/7-36 6/7 weeks) account for an increasing proportion of prematurity-associated short-term morbidities, particularly respiratory, that require specialized care and prolonged neonatal hospital stays. Objective: To assess short-term respiratory morbidity in late preterm births compared with term births in a contemporary cohort of deliveries in the United States. Design, Setting, and Participants: Retrospective collection of electronic data from 12 institutions (19 hospitals) across the United States on 233 844 deliveries between 2002 and 2008. Charts were abstracted for all neonates with respiratory compromise admitted to a neonatal intensive care unit (NICU), and late preterm births were compared with term births in regard to resuscitation, respiratory support, and respiratory diagnoses. A multivariate logistic regression analysis compared infants at each gestational week, controlling for factors that influence respiratory outcomes. Main Outcome Measures: Respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, respiratory failure, and standard and oscillatory ventilator support. Results: Of 19 334 late preterm births, 7055 (36.5%) were admitted to a NICU and 2032 had respiratory compromise. Of 165 993 term infants, 11 980 (7.2%) were admitted to a NICU, 1874 with respiratory morbidity. The incidence of respiratory distress syndrome was 10.5% (390/3700) for infants born at 34 weeks' gestation vs 0.3% (140/41 764) at 38 weeks. Similarly, incidence of transient tachypnea of the newborn was 6.4%(n=236) for those born at 34 weeks vs 0.4% (n=155) at 38 weeks, pneumonia was 1.5% (n=55) vs 0.1% (n=62), and respiratory failure was 1.6% (n=61) vs 0.2% (n=63). Standard and oscillatory ventilator support had similar patterns. Odds of respiratory distress syndrome decreased with each advancing week of gestation until 38 weeks compared with 39 to 40 weeks (adjusted odds ratio [OR] at 34 weeks, 40.1; 95% confidence interval [CI], 32.0-50.3 and at 38 weeks, 1.1; 95% CI, 0.9-1.4). At 37 weeks, odds of respiratory distress syndrome were greater than at 39 to 40 weeks (adjusted OR, 3.1; 95% CI, 2.5-3.7), but the odds at 38 weeks did not differ from 39 to 40 weeks. Similar patterns were noted for transient tachypnea of the newborn (adjusted OR at 34 weeks, 14.7; 95% CI, 11.7-18.4 and at 38 weeks, 1.0; 95% CI, 0.8-1.2), pneumonia (adjusted OR at 34 weeks, 7.6; 95% CI, 5.2-11.2 and at 38 weeks, 0.9; 95% CI, 0.6-1.2), and respiratory failure (adjusted OR at 34 weeks, 10.5; 95% CI, 6.9-16.1 and at 38 weeks, 1.4; 95% CI, 1.0-1.9). Conclusion: In a contemporary cohort, late preterm birth, compared with term delivery, was associated with increased risk of respiratory distress syndrome and other respiratory morbidity.
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U2 - 10.1001/jama.2010.1015
DO - 10.1001/jama.2010.1015
M3 - Article
C2 - 20664042
AN - SCOPUS:77954992484
VL - 304
SP - 419
EP - 425
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
SN - 0098-7484
IS - 4
ER -