6652 Late preterm infants: where to go?

Objectives In response to the 2023 BAPM Framework on late preterm infants, we reviewed a cohort of these infants born in our local neonatal unit and compared them to the framework.¹ Specifically we evaluated whether the place of care (Postnatal ward (PNW) vs Transitional Care (TC)) influenced the journey of our late preterm infants. Methods Data was collected retrospectively from the BadgerNet software for infants born between 34+0 and 36+6 weeks gestation from 1 January 2022 to 31 December 2022. We concentrated on common morbidities like hypothermia and hypoglycaemia, need for admission to the Neonatal Unit (NNU), and breastfeeding rates. We also evaluated our practice in providing antenatal counselling. Results 203 infants were included in our analysis. The initial destination of care compared to where infants were discharged from is summarised in table 1. 61% of 34 week infants were admitted to the Neonatal Unit during their inpatient journey. Rate of admission NNU decreased with increasing maturity with 52% in the 35 week group and 37% in the 36 week group. The most common reason for admission across all gestations was respiratory distress. In the 34 and 35 week groups, infants who were initially nursed in TC were less likely to be admitted to NNU. In the 36 week category, TC was more likely to be used as a step down destination of care from NNU. Neonatal morbidity Common neonatal morbidities of hypothermia, hypoglycaemia, jaundice and infection are stratified according to gestational age in table 2. 35 week infants were more likely to be admitted to NNU with hypoglycaemia if they were initially nursed in PNW compared to TC. Breastfeeding rates 34 week infants were more likely to receive their mother's expressed breastmilk if they were discharged from NNU. 35 week infants were more likely to go home breastfeeding if they were discharged from TC. Antenatal Counselling Only 7% of families were counselled antenatal. Conclusion Better utilisation of TC may reduce separation of infants from their mothers and increase breastfeeding rates particularly in the 35 week gestation group. This study has highlighted the need for better education for staff and parents. Reference British Association of Perinatal Medicine. Early postnatal care of the moderate-late preterm infant a framework for practice January 2023 https://hubble-live-assets.s3.eu-west-1.amazonaws.com/bapm/file_asset/file/1641/Postnatal_Care_Moderate-Late_Preterm_Infant_FINAL_300123.pdf. Accessed 30/8/23.