Short‐Term Outcomes of Early‐Term Versus Full‐Term and Late‐Term Neonates: A Systematic Review and Meta‐Analysis

Background Early‐term births constitute 15%–31% of global births; its impact on neonates is under‐recognised. Objectives To systematically synthesise current evidence comparing short‐term neonatal outcomes between early‐term and full‐/late‐term births globally and in low‐ and middle‐income countries (LMICs). Search Strategy PubMed and Embase databases were searched from inception to 13 March 2025. Selection Criteria Studies comparing short‐term neonatal outcomes (e.g., morbidity, respiratory complications) among early‐term (37–38 weeks' gestation), full‐term (39–40 weeks) and late‐term (41 weeks) births were included. Studies involving multiple pregnancies were excluded. Data Collection and Analysis Using PRISMA guidelines, two investigators independently screened studies, extracted data and assessed risk of bias. Meta‐analyses employed a random‐effects model to estimate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Main Results Thirty‐five studies, medium to high quality, from 15 countries ( n = 13 784 259) were included. Eight studies ( n = 75 081) were from LMICs. Early‐term neonates had higher risks of respiratory distress syndrome (OR 2.85, 95% CI: 2.09–3.90), transient tachypnoea of the newborn (OR 2.00, 95% CI: 1.65–2.42) and composite respiratory morbidities (OR 1.75, 95% CI: 1.48–2.08) compared to full‐term and late‐term neonates. In LMICs, early‐term neonates had an even higher risk of respiratory distress syndrome (OR 4.77, 95% CI: 1.83–12.44). However, limited data from LMICs reduced the generalisability of findings. The need for mechanical ventilation (OR 2.08, 95% CI: 1.83–2.38), continuous positive airway pressure (OR 2.41, 95% CI: 1.88–3.09) and oxygen therapy (OR 1.88, 95% CI: 1.48–2.39) was also higher in early‐term neonates. Conclusions Early‐term neonates face higher risks of short‐term adverse consequences, underscoring the need for heightened vigilance in perinatal management strategies to optimise outcomes for this vulnerable population. Prospero Registration CRD42024556551 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=556551 )