Perinatal outcomes of spontaneous and medically-indicated late preterm infants

Objective: The aim of the study was to compare the perinatal results of spontaneous and medically-indicated late-preterm infants. Methods:We conducted a retrospective cohort study including all singleton late-preterm infants born at our University Hospital between January 2009 and December 2010 (n=171).Neonates with congenital infections, major congenital malformations and chromosomal abnormalities were excluded.Late-preterm infants were classified into two groups, spontaneous and medically-indicated, according to delivery indication.Obstetric complications and short-term neonatal outcomes were investigated.Results: 145 late-preterm infants were eligible for analysis.Obstetric complications were more frequent in medically-indicated late-preterm infants.However, when neonatal results were compared no differences were found between groups.Both spontaneous and medically-indicated late-preterm infants were at risk to develop respiratory morbidity (14.5% vs 24.2%, p=0.195), hyperbilirubinemia (15.7% vs 11.3%, p=0.478), excessive weight loss (2.4% vs 4.8%, p =0.651), infectious complications (1.2% vs 8.1%, p =0.084) and central nervous system morbidity (2.4% vs 0%, p=0.507).Only length of hospital stay was significantly higher among medically-indicated late-preterm infants.Conclusions: Both spontaneous and medically-indicated late-preterm infants are at risk for perinatal morbidity.Obstetric management of pregnancies at risk for late-preterm prematurity should be clarified, and specific strategies of care for these infants need to be improved.