Caring for Late Preterm Infants: New Guidelines

By Haley Burton

November 28, 2012 Updated Dec 5, 2012 at 11:07 AM EDT

(WBNG Binghamton) In the U.S., more than a half a million babies are born premature each year. 75 percent of those are late preterm infants.

The National Perinatal Association says late preterm infants are at a higher risk for short and long-term health challenges requiring increased levels of assessment and care.

Late preterm infants are classified as those born between 34 and 36 6/7 weeks gestational age.

"They just look like tinier versions of a normal baby and they're really not all that much tiny," said Sharon Chesna, Executive Director of Mothers and Babies Perinatal Network.

The Association released the Multidisciplinary Guidelines for the Care of Late Preterm Infants. It was created to evidence-based instructions and tools on the management and care of late preterm infants.

"Professionals across all disciplines developed these guidelines. We had nurses and social workers, neonatologists, perinatologists, and normal obstetricians and community health care workers such as myself," said Sharon Chesna, Executive Director of Mothers and Babies Perinatal Network.

Chesna also sits on the National Perinatal Association board.

17 national organizations came together to work on the guidelines. It addresses care from the in-hospital setting immediately after birth, through the transition to home.

"There are sections of the guidelines that really speak to how to assess the newborn in the hospital, what time of care they may need if they are admitted to the NICU, what kind of discharge instructions parents should receive," said Chesna, "The goal is that every hospital would actually have them. Ideally all the pediatricians, neonatologists would be aware of them as well as community organizations such as Mothers and Babies so we can share this information for parents as they bring these new babies home."

The National Perinatal Association says late preterm infants have higher rates of morbidity and mortality than full term babies, account for up to 20 percent of all NICU admissions.

"The re-hospitalization within a couple of weeks of birth, the incidents of jaundice, not eating well, poor nutritional habits, poor respiratory problems are absolutely classic with late preterm babies because sometimes they are just assessed as fully as very preterm-term baby would have been," said Chesna.

Late preterm babies also have higher costs across every medical category compared to full-term infants.

Christie Finch's daughter, Arianna, was born at 36 1/7 weeks gestation. There were no complications at birth and the two went home after two days.

Shortly after, Arianna experienced issues including feeding, jaundice and RSV. She was in and out of the hospital for years.

"She would be fine and then she'd get a cold and as soon as she got a cold, it would attack her chest and she couldn't breath and she would have to go to the hospital or we'd end up in the emergency room," said Finch, who lives in the Town of Maine.

Arianna now has ongoing asthma related issues that require medications. Arianna also has ongoing developmental issues both cognitively as well as behavior which she receives occupational therapy to help with.

"With the new guidelines, if they would've checked her out in the hospital and the recommendations say we would've been back at the pediatric office in a couple of days. They would've picked up on it," said Finch, "I think the more we think about late preterm infants and babies born just a little bit too early, the more we can say 'This is what we should be doing for them and this is what we should watch out for.'"

The guidelines provide a roadmap to parents and providers that focus on attention on specific needs from birth through early childhood, helping to ensure potential health issues aren't overlooked.

The guidelines are available for free by clicking here.