Late Preterm Infants

Late Preterm Infants—out of the woods?

by Candy on April 15, 2009 No comments

I am pleased to see, albeit sad to hear, the news media bring attention to the recent study results about developmental problems among Late Preterm Infants. I represent a national community of NICU nurses, who has been conscientiously lobbying to change the increase in late preterm births, for over a decade.

It is true that these elective cesarean sections are often brought on by real medical problems. However, the cavalier attitude of some obstetricians seems to be rooted in the fact that in the US, NICUs “produce miracles all the time,” as one OB argued. This has led to a measurable increase in “Monday-Friday” c-sections, as thoughtful physicians plan their patient’s deliveries around their own weekend plans.

My research for the film, Micropremature Babies: How Low Can You Go? included many interviews with families of micropremature and late preterm (ie, 34-36 weeks gestation) infants. Generally, the news was encouraging and hopeful. But visits to several developmental clinics convinced me that there is a variable within our treatment in the NICUs that cannot yet be explained. We expect our micropremature or very low birth weight infants to need up to three years to catch up to their peers born at 38-40 weeks, yet we do not expect our 34-36 weekers to have negative sequelae… Why not? Turn back the clock 50 years and these babies would have been considered very fragile. Medical technology has advanced, but has that impacted the fragility of a late preterm infant?

The difference between today and 50 years ago, is that now we have babies born early and earlier. Any preterm birth includes the possibility of a large spectrum of problems as well as triumphs. As a patient advocate, and as a mom, I urge all parents to be proactive and not in a hurry to be delivered of their late preterm infant, unless it is truly a medical emergency. Do not be lulled into a false sense of security by an obstetrician who tells you that the baby will be fine just because the L/S ratio is within normal limits. (That screening tool is not 100% accurate.)

And now I’ll step off the soapbox…

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CandyLate Preterm Infants—out of the woods?