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Risk of Poor Neonatal Outcome Up With Decreasing Gestation

Health outcomes at age 3 and 5 years worse for those born moderate/late preterm or early term

FRIDAY, March 2 (HealthDay News) -- The health outcomes of infants born moderate/late preterm or early term are worse than those born full term, with a gradient of increasing risk with decreasing gestation, according to a study published online March 1 in BMJ.

Elaine M. Boyle, M.B., Ch.B., from the University of Leicester in the United Kingdom, and colleagues conducted a secondary analysis of data from 18,818 infants from the Millennium Cohort Study to investigate the burden of later disease associated with moderate/late preterm and early term births (32 to 36 weeks and 37 to 38 weeks, respectively). Health outcomes were measured at age 3 (14,273 children) and 5 (14,056 children) years.

The researchers found that there was a gradient of increasing risk of poorer outcome with decreasing gestation for measures of general health, hospital admissions, and longstanding illness. Being born in late/moderate preterm or early term was the greatest contribution to disease burden at ages 3 and 5 years. For moderate/late preterm birth and early term birth, compared with very preterm birth (before 32 weeks), the population attributable fraction of having at least three hospital admissions between 9 months and 5 years was 5.7, 7.2, and 3.8 percent, respectively. Likewise, the population attributable fraction for limiting longstanding illness at 5 years was 5.4 percent for early term birth, 5.4 percent for moderate/late preterm birth, and 2.7 percent for very preterm birth.

"Continuing to view health outcomes of babies as dichotomous preterm/term outcomes is inappropriate, as our study shows a continuum of increasing risk of adverse outcome with increasing prematurity, even approaching full term gestation," the authors write.

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