Respiratory morbidity in late preterm births

Judith U. Hibbard, Isabelle Wilkins, Liping Sun, Kimberly Gregory, Shoshana Haberman, Matthew Hoffman, Michelle A. Kominiarek, Uma Reddy, Jennifer Bailit, D. Ware Branch, Ronald Burkman, Victor Hugo Gonzalez Quintero, Christos G. Hatjis, Helain Landy, Mildred Ramirez, Paul VanVeldhuisen, James Troendle, Jun Zhang

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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 languageEnglish (US)
Pages (from-to)419-425
Number of pages7
JournalJAMA - Journal of the American Medical Association
Volume304
Issue number4
DOIs
StatePublished - Jul 28 2010

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Premature Birth
Confidence Intervals
Morbidity
Transient Tachypnea of the Newborn
Odds Ratio
Neonatal Intensive Care Units
Respiratory Insufficiency
Term Birth
Pneumonia
Mechanical Ventilators
Pregnancy
Incidence
Resuscitation
Length of Stay
Logistic Models
Regression Analysis
Outcome Assessment (Health Care)
Newborn Infant

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hibbard, J. U., Wilkins, I., Sun, L., Gregory, K., Haberman, S., Hoffman, M., ... Zhang, J. (2010). Respiratory morbidity in late preterm births. JAMA - Journal of the American Medical Association, 304(4), 419-425. https://doi.org/10.1001/jama.2010.1015
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. / Respiratory morbidity in late preterm births. In: JAMA - Journal of the American Medical Association. 2010 ; Vol. 304, No. 4. pp. 419-425.
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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.",
author = "Hibbard, {Judith U.} and Isabelle Wilkins and Liping Sun and Kimberly Gregory and Shoshana Haberman and Matthew Hoffman and Kominiarek, {Michelle A.} and Uma Reddy and Jennifer Bailit and Branch, {D. Ware} and Ronald Burkman and Quintero, {Victor Hugo Gonzalez} and Hatjis, {Christos G.} and Helain Landy and Mildred Ramirez and Paul VanVeldhuisen and James Troendle and Jun Zhang",
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Hibbard, JU, Wilkins, I, Sun, L, Gregory, K, Haberman, S, Hoffman, M, Kominiarek, MA, Reddy, U, Bailit, J, Branch, DW, Burkman, R, Quintero, VHG, Hatjis, CG, Landy, H, Ramirez, M, VanVeldhuisen, P, Troendle, J & Zhang, J 2010, 'Respiratory morbidity in late preterm births', JAMA - Journal of the American Medical Association, vol. 304, no. 4, pp. 419-425. https://doi.org/10.1001/jama.2010.1015

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 journalArticle

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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Hibbard JU, Wilkins I, Sun L, Gregory K, Haberman S, Hoffman M et al. Respiratory morbidity in late preterm births. JAMA - Journal of the American Medical Association. 2010 Jul 28;304(4):419-425. https://doi.org/10.1001/jama.2010.1015