Late preterm pregnancy and the newborn:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
2006
|
| Series: | Clinics in perinatology
33,4 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XVI S., S. 752 - 972 Ill., graph. Darst. |
| ISBN: | 141603899X 9781416038993 |
Staff View
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Record in the Search Index
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| adam_text | CONTENTS
Preface xv
Lucky Jain and Tonse N.K. Raju
Epidemiology of Late Preterm (Near Term) Births 751
Tonse N.K. Raju
The preterm birth rate (births before 37 completed weeks of gesta
tion) has been increasing in the United States, largely driven by an
increase in infants delivered between 34 and 36 weeks, often called
near term, but referred to as late preterm in this article. In 2004, the
preterm birth rate was 12.5%, the highest rate since the National
Center for Health Statistics began tracking such data. This article
reviews the epidemiology of late preterm births and proposes a re
search agenda.
Late Preterm Gestation: Physiology of Labor
and Implications for Delivery 765
William J. Dobak and Michael O. Gardner
The late preterm infant represents a significant portion of preterm
deliveries. Historically, this cohort has been referred to as near
term, which may not address adequately the increased perinatal
morbidity these neonates experience. The changing demographics
of pregnant women also are increasing the number of inductions
in this gestational age group. More women with chronic hyperten
sion, diabetes, and other chronic medical problems are getting
pregnant, and often these pregnancies may require induction dur
ing this gestational age. The increasing numbers of multi fetal ge
stations also have an average gestational age at delivery in this
ränge of 34 to 36.6 weeks. Preeclampsia is another factor that can
lead to delivery and induction during this gestational age. This ar¬
ticle discusses some of the physiologic causes behind late preterm
deliveries.
VOLUME 33 • NUMBER 4 • DECEMBER 2006 vii
The Impact of Multiple Gestations on Late Preterm
(Near Term) Births 777
Young Mi Lee, Jane Cleary Goldman, and Mary E. D Alton
Multiple pregnancies currently account for 3% of all births in the
United States but are disproportionately responsible for larger rates
of prematurity and significant neonatal morbidity. The mean birth
age for most multi fetal pregnancies occurs during the late preterm
period when both spontaneous preterm labor and iatrogenic pre¬
mature birth because of obstetrical or maternal complications are
common. Multiples pose numerous unique challenges, emphasiz¬
ing the significant impact of plurality on late preterm births.
Elective Cesarean Section and Induction and Their Impact
on Late Preterm Births 793
Karin Fuchs and Ronald Wapner
At all gestational ages, the risks of continuing a pregnancy must be
carefully balanced against the risks of delivery and the associated
risk of prematurity. This concept is of increasing importance in late
preterm pregnancy when medical or obstetric complications fre¬
quently warrant delivery and the risk of prematurity persists.
Given that morbidity exists for infants born between 34 and 37
weeks gestation, efforts should be focused on minimizing the late
preterm birth rate and at improving the outcome of these infants.
Published guidelines outlining the appropriate timing of elective
induction of labor and elective Cesarean section should be closely
followed to avoid unintended iatrogenic prematurity. Research
should continue to investigate the etiology of spontaneous preterm
deliveries and aim to develop strategies of primary prevention. The
incidence and etiology of iatrogenic late preterm birth should also
be further investigated and alternative management strategies
should be considered. To gain information about the impact of elec¬
tive delivery on late preterm births, the data collected from birth
records should reflect the changing obstetric practices in the United
States and be revised to include specific information on elective
deliveries.
Hypoxic Respiratory Failure in the Late Preterm Infant 803
Golde G. Dudell and Lucky Jain
Hypoxic respiratory failure in late preterm infants has received in¬
creased attention in the last decade, and while the incidence is low,
it accounts for a significant number of admissions to neonatal ICUs
because of the large number of late preterm births in the United
States and worldwide. Causes of respiratory distress include tran¬
sient tachypnea of the newborn, surfactant deficiency, pneumonia,
and pulmonary hypertension. The physiologic mechanisms under¬
lying delayed transition caused by surfactant deficiency and poor
fetal lung fluid absorption have been reviewed recently elsewhere.
viii CONTENTS
This article focuses on the less explored problem of severe hypoxic
respiratory failure in the late preterm infant and discusses potential
strategies for management.
Feeding Problems in the Late Preterm Infant 831
David H. Adamkin
Much of the neonatal nutrition literature has focused on the man¬
agement of very low birth weight infants, a group of infants usually
less than 33 weeks gestation. Much less attention has been paid to
nutritional management issues in preterm infants at higher gesta¬
tions. This article reviews nutritional issues that exist from the
239th day (34 0/7 weeks gestation) and ending on the 259th day
(36 6/7 weeks gestation) since the first day of the mother s last nor¬
mal menstrual period.
Hyperbilirubinemia and Bilirubin Toxicity in the Late
Preterm Infant 839
Jon F. Watchko
Late preterm gestation is an important risk factor for the develop¬
ment of severe neonatal hyperbilirubinemia and kernicterus. An
exaggerated hepatic immaturity contributes to the greater preva¬
lence, severity, and duration of neonatal jaundice in late preterm in¬
fants. Breast milk feeding is almost uniformly present and large for
gestational age status, male sex, and G6PD deficiency are over
represented among that cohort of late preterm infants with kernic¬
terus. Attention to screening measures for jaundice in the newborn
nursery, the provision of lactation support, parental education,
timely postdischarge follow up, and appropriate treatment when
clinically indicated should help to reduce the risk of late preterm
neonates developing severe neonatal jaundice or kernicterus.
Glucose Metabolism in the Late Preterm Infant 853
Meena Garg and Sherin U. Devaskar
Prematurity and low birth weight are important determinants of
neonatal morbidity and mortality. A rising trend of preterm births
is caused by an increase in the birth rate of near term infants. Near
term infants are defined as infants of 34 to 36 6/7 weeks gestation.
It is dangerous to assume that the incidence of hypoglycemia in the
late preterm infant is similar to the infant born at full term.
Although current methods for assessing effects of hypoglycemia
are imperfect, the injury to central nervous system depends on
the degree of prematurity, presence of intrauterine growth restric¬
tion (IUGR), intrauterine compromise, genotype, blood flow, meta¬
bolic rate, and availability of other substrates. Therefore, early
recognition of glucose metabolic abnormalities pertaining to late
preterm infants is essential to provide appropriate and timely inter¬
ventions in the newborn nursery. Although many of the investiga¬
tions have targeted full term infants, premature infants inclusive of
CONTENTS ix
the extremely low birth weight infants and the intrauterine growth
restricted infants, adequately powered studies restricted to only the
late preterm infants are required and need future consideration.
Infection in Late Preterm Infants 871
Daniel K. Benjamin, Jr and Barbara J. Stoll
Late preterm neonates have unique susceptibilities to infection. The
closed setting of the neonatal ICU (NICU) and the immunologic
immaturity of premature infants set the stage for the development
of nosocomial infections. This article discusses infections that might
be seen in this population and gives options for diagnosis and
treatment.
The Late Preterm Infant and the Control of Breathing,
Sleep, and Brainstem Development: A Review 883
Robert A. Darnall, Ronald L. Ariagno,
and Hannah C. Kinney
The brainstem development of infants born between 33 and 38
weeks gestation is less mature than that of a full term infant. Dur¬
ing late gestation, there are dramatic and nonlinear developmental
changes in the brainstem. This translates into immaturity of upper
airway and lung volume control, laryngeal reflexes, chemical con¬
trol of breathing, and sleep mechanisms. Ten percent of late pre¬
term infants have significant apnea of prematurity and they
frequently have delays in establishing coordination of feeding
and breathing. Unfortunately, there is a paucity of clinical, physio¬
logic, neuroanatomic, and neurochemical data in this specific
group of infants. Research focused on this group of infants will
not only further our understanding of brainstem maturation dur¬
ing this high risk period, but will help develop focused plans for
their management.
Is the Late Preterm Infant More Vulnerable to Gray Matter
Injury than the Term Infant? 915
Saraid S. Billiards, Christopher R. Pierson, Robin L. Haynes,
Rebecca D. Folkerth, and Hannah C. Kinney
This article addresses the issue of whether the late preterm infant is
more susceptible to gray matter injury induced by hypoxia ische
mia than the term infant. Although different gray matter regions
display varying patterns of neuronal injury in the face of hypoxia
ischemia during advancing gestational development, little is
known about the specific patterns of injury faced by the late pre¬
term infant. This changing pattern of neuronal vulnerability with
age likely reflects developmental changes of susceptibility and pro¬
tective factors essential for responding to energy deprivation at the
molecular, cellular, biochemical, and vascular levels. Future re¬
search involving closer examination of the late preterm period is
X CONTENTS
essential to provide a greater understanding of the neuronal vul¬
nerability in the face of hypoxic ischemic injury.
Emergency Department Visits and Rehospitalizations
in Late Preterm Infants 935
Shabnam Jain and John Cheng
The number of late preterm newborns (gestational age 34 to 36
weeks) is increasing in the United States and Canada. The appear¬
ance of these newborns may give a false sense of security about
their well being to practitioners and parents alike. Neonatology lit¬
erature has begun to address this issue; however there is paucity of
information regarding health concerns of these newborns after dis¬
charge from the nursery. The authors reviewed their experience in
the emergency department (ED) of a large pediatric institution over
a 1 year period, comparing morbidity in late preterm infants with
term infants. Late preterm infants comprise a significant proportion
of newborn visits to the ED. Certain problems occur more fre¬
quently in these infants, including the need for intensive care.
Neurodevelopmental Outcome of the Late Preterm Infant 947
Ira Adams Chapman
There is very limited information about the developmental out¬
come of the late preterm infant. The developing brain is vulnerable
to injury during this very active and important stage of fetal brain
development; therefore, it is important to carefully monitor the
neurologic outcome of these infants. This article discusses gesta¬
tional brain development and complications of late preterm birth
that contribute to the overall risk of brain injury.
Index 965
CONTENTS xi
|
| adam_txt |
CONTENTS
Preface xv
Lucky Jain and Tonse N.K. Raju
Epidemiology of Late Preterm (Near Term) Births 751
Tonse N.K. Raju
The preterm birth rate (births before 37 completed weeks of gesta
tion) has been increasing in the United States, largely driven by an
increase in infants delivered between 34 and 36 weeks, often called
near term, but referred to as late preterm in this article. In 2004, the
preterm birth rate was 12.5%, the highest rate since the National
Center for Health Statistics began tracking such data. This article
reviews the epidemiology of late preterm births and proposes a re
search agenda.
Late Preterm Gestation: Physiology of Labor
and Implications for Delivery 765
William J. Dobak and Michael O. Gardner
The late preterm infant represents a significant portion of preterm
deliveries. Historically, this cohort has been referred to as near
term, which may not address adequately the increased perinatal
morbidity these neonates experience. The changing demographics
of pregnant women also are increasing the number of inductions
in this gestational age group. More women with chronic hyperten
sion, diabetes, and other chronic medical problems are getting
pregnant, and often these pregnancies may require induction dur
ing this gestational age. The increasing numbers of multi fetal ge
stations also have an average gestational age at delivery in this
ränge of 34 to 36.6 weeks. Preeclampsia is another factor that can
lead to delivery and induction during this gestational age. This ar¬
ticle discusses some of the physiologic causes behind late preterm
deliveries.
VOLUME 33 • NUMBER 4 • DECEMBER 2006 vii
The Impact of Multiple Gestations on Late Preterm
(Near Term) Births 777
Young Mi Lee, Jane Cleary Goldman, and Mary E. D'Alton
Multiple pregnancies currently account for 3% of all births in the
United States but are disproportionately responsible for larger rates
of prematurity and significant neonatal morbidity. The mean birth
age for most multi fetal pregnancies occurs during the late preterm
period when both spontaneous preterm labor and iatrogenic pre¬
mature birth because of obstetrical or maternal complications are
common. Multiples pose numerous unique challenges, emphasiz¬
ing the significant impact of plurality on late preterm births.
Elective Cesarean Section and Induction and Their Impact
on Late Preterm Births 793
Karin Fuchs and Ronald Wapner
At all gestational ages, the risks of continuing a pregnancy must be
carefully balanced against the risks of delivery and the associated
risk of prematurity. This concept is of increasing importance in late
preterm pregnancy when medical or obstetric complications fre¬
quently warrant delivery and the risk of prematurity persists.
Given that morbidity exists for infants born between 34 and 37
weeks gestation, efforts should be focused on minimizing the late
preterm birth rate and at improving the outcome of these infants.
Published guidelines outlining the appropriate timing of elective
induction of labor and elective Cesarean section should be closely
followed to avoid unintended iatrogenic prematurity. Research
should continue to investigate the etiology of spontaneous preterm
deliveries and aim to develop strategies of primary prevention. The
incidence and etiology of iatrogenic late preterm birth should also
be further investigated and alternative management strategies
should be considered. To gain information about the impact of elec¬
tive delivery on late preterm births, the data collected from birth
records should reflect the changing obstetric practices in the United
States and be revised to include specific information on elective
deliveries.
Hypoxic Respiratory Failure in the Late Preterm Infant 803
Golde G. Dudell and Lucky Jain
Hypoxic respiratory failure in late preterm infants has received in¬
creased attention in the last decade, and while the incidence is low,
it accounts for a significant number of admissions to neonatal ICUs
because of the large number of late preterm births in the United
States and worldwide. Causes of respiratory distress include tran¬
sient tachypnea of the newborn, surfactant deficiency, pneumonia,
and pulmonary hypertension. The physiologic mechanisms under¬
lying delayed transition caused by surfactant deficiency and poor
fetal lung fluid absorption have been reviewed recently elsewhere.
viii CONTENTS
This article focuses on the less explored problem of severe hypoxic
respiratory failure in the late preterm infant and discusses potential
strategies for management.
Feeding Problems in the Late Preterm Infant 831
David H. Adamkin
Much of the neonatal nutrition literature has focused on the man¬
agement of very low birth weight infants, a group of infants usually
less than 33 weeks gestation. Much less attention has been paid to
nutritional management issues in preterm infants at higher gesta¬
tions. This article reviews nutritional issues that exist from the
239th day (34 0/7 weeks gestation) and ending on the 259th day
(36 6/7 weeks gestation) since the first day of the mother's last nor¬
mal menstrual period.
Hyperbilirubinemia and Bilirubin Toxicity in the Late
Preterm Infant 839
Jon F. Watchko
Late preterm gestation is an important risk factor for the develop¬
ment of severe neonatal hyperbilirubinemia and kernicterus. An
exaggerated hepatic immaturity contributes to the greater preva¬
lence, severity, and duration of neonatal jaundice in late preterm in¬
fants. Breast milk feeding is almost uniformly present and large for
gestational age status, male sex, and G6PD deficiency are over
represented among that cohort of late preterm infants with kernic¬
terus. Attention to screening measures for jaundice in the newborn
nursery, the provision of lactation support, parental education,
timely postdischarge follow up, and appropriate treatment when
clinically indicated should help to reduce the risk of late preterm
neonates developing severe neonatal jaundice or kernicterus.
Glucose Metabolism in the Late Preterm Infant 853
Meena Garg and Sherin U. Devaskar
Prematurity and low birth weight are important determinants of
neonatal morbidity and mortality. A rising trend of preterm births
is caused by an increase in the birth rate of near term infants. Near
term infants are defined as infants of 34 to 36 6/7 weeks gestation.
It is dangerous to assume that the incidence of hypoglycemia in the
late preterm infant is similar to the infant born at full term.
Although current methods for assessing effects of hypoglycemia
are imperfect, the injury to central nervous system depends on
the degree of prematurity, presence of intrauterine growth restric¬
tion (IUGR), intrauterine compromise, genotype, blood flow, meta¬
bolic rate, and availability of other substrates. Therefore, early
recognition of glucose metabolic abnormalities pertaining to late
preterm infants is essential to provide appropriate and timely inter¬
ventions in the newborn nursery. Although many of the investiga¬
tions have targeted full term infants, premature infants inclusive of
CONTENTS ix
the extremely low birth weight infants and the intrauterine growth
restricted infants, adequately powered studies restricted to only the
late preterm infants are required and need future consideration.
Infection in Late Preterm Infants 871
Daniel K. Benjamin, Jr and Barbara J. Stoll
Late preterm neonates have unique susceptibilities to infection. The
closed setting of the neonatal ICU (NICU) and the immunologic
immaturity of premature infants set the stage for the development
of nosocomial infections. This article discusses infections that might
be seen in this population and gives options for diagnosis and
treatment.
The Late Preterm Infant and the Control of Breathing,
Sleep, and Brainstem Development: A Review 883
Robert A. Darnall, Ronald L. Ariagno,
and Hannah C. Kinney
The brainstem development of infants born between 33 and 38
weeks' gestation is less mature than that of a full term infant. Dur¬
ing late gestation, there are dramatic and nonlinear developmental
changes in the brainstem. This translates into immaturity of upper
airway and lung volume control, laryngeal reflexes, chemical con¬
trol of breathing, and sleep mechanisms. Ten percent of late pre¬
term infants have significant apnea of prematurity and they
frequently have delays in establishing coordination of feeding
and breathing. Unfortunately, there is a paucity of clinical, physio¬
logic, neuroanatomic, and neurochemical data in this specific
group of infants. Research focused on this group of infants will
not only further our understanding of brainstem maturation dur¬
ing this high risk period, but will help develop focused plans for
their management.
Is the Late Preterm Infant More Vulnerable to Gray Matter
Injury than the Term Infant? 915
Saraid S. Billiards, Christopher R. Pierson, Robin L. Haynes,
Rebecca D. Folkerth, and Hannah C. Kinney
This article addresses the issue of whether the late preterm infant is
more susceptible to gray matter injury induced by hypoxia ische
mia than the term infant. Although different gray matter regions
display varying patterns of neuronal injury in the face of hypoxia
ischemia during advancing gestational development, little is
known about the specific patterns of injury faced by the late pre¬
term infant. This changing pattern of neuronal vulnerability with
age likely reflects developmental changes of susceptibility and pro¬
tective factors essential for responding to energy deprivation at the
molecular, cellular, biochemical, and vascular levels. Future re¬
search involving closer examination of the late preterm period is
X CONTENTS
essential to provide a greater understanding of the neuronal vul¬
nerability in the face of hypoxic ischemic injury.
Emergency Department Visits and Rehospitalizations
in Late Preterm Infants 935
Shabnam Jain and John Cheng
The number of late preterm newborns (gestational age 34 to 36
weeks) is increasing in the United States and Canada. The appear¬
ance of these newborns may give a false sense of security about
their well being to practitioners and parents alike. Neonatology lit¬
erature has begun to address this issue; however there is paucity of
information regarding health concerns of these newborns after dis¬
charge from the nursery. The authors reviewed their experience in
the emergency department (ED) of a large pediatric institution over
a 1 year period, comparing morbidity in late preterm infants with
term infants. Late preterm infants comprise a significant proportion
of newborn visits to the ED. Certain problems occur more fre¬
quently in these infants, including the need for intensive care.
Neurodevelopmental Outcome of the Late Preterm Infant 947
Ira Adams Chapman
There is very limited information about the developmental out¬
come of the late preterm infant. The developing brain is vulnerable
to injury during this very active and important stage of fetal brain
development; therefore, it is important to carefully monitor the
neurologic outcome of these infants. This article discusses gesta¬
tional brain development and complications of late preterm birth
that contribute to the overall risk of brain injury.
Index 965
CONTENTS xi |
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| index_date | 2024-07-02T16:32:31Z |
| indexdate | 2024-07-09T20:52:55Z |
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| isbn | 141603899X 9781416038993 |
| language | English |
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| series | Clinics in perinatology |
| series2 | Clinics in perinatology |
| spelling | Late preterm pregnancy and the newborn guest eds.: Lucky Jain ... Philadelphia [u.a.] Saunders 2006 XVI S., S. 752 - 972 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Clinics in perinatology 33,4 Pasgeborenen gtt Prematuren gtt Infant, Newborn Infant, Premature growth & development Infant, Premature metabolism Pregnancy Complications Jain, Lucky Sonstige (DE-588)138681384 oth Clinics in perinatology 33,4 (DE-604)BV000003382 33,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=015442086&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Late preterm pregnancy and the newborn Clinics in perinatology Pasgeborenen gtt Prematuren gtt Infant, Newborn Infant, Premature growth & development Infant, Premature metabolism Pregnancy Complications |
| title | Late preterm pregnancy and the newborn |
| title_auth | Late preterm pregnancy and the newborn |
| title_exact_search | Late preterm pregnancy and the newborn |
| title_exact_search_txtP | Late preterm pregnancy and the newborn |
| title_full | Late preterm pregnancy and the newborn guest eds.: Lucky Jain ... |
| title_fullStr | Late preterm pregnancy and the newborn guest eds.: Lucky Jain ... |
| title_full_unstemmed | Late preterm pregnancy and the newborn guest eds.: Lucky Jain ... |
| title_short | Late preterm pregnancy and the newborn |
| title_sort | late preterm pregnancy and the newborn |
| topic | Pasgeborenen gtt Prematuren gtt Infant, Newborn Infant, Premature growth & development Infant, Premature metabolism Pregnancy Complications |
| topic_facet | Pasgeborenen Prematuren Infant, Newborn Infant, Premature growth & development Infant, Premature metabolism Pregnancy Complications |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=015442086&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| volume_link | (DE-604)BV000003382 |
| work_keys_str_mv | AT jainlucky latepretermpregnancyandthenewborn |