441 Neonatal Morbidity in Moderately Preterm Infants. A Swedish National Population-Based Study

Abstract

Objective: To determine the gestational age specific risks for neonatal morbidity, interventions and treatments in infants born at the crossroads between very and moderately preterm.Study design: A population-based Swedish study including 6,674 infants born at 30 to 34 weeks of gestational age (GA) during 2004-2008. Risks for neonatal morbidity and use of interventions were investigated with respect to GA and birth weight standard deviation scores.Results: Acute lung disorder was diagnosed in 28%, hypoglycemia in 16%, bacterial infection in 15% and hyperbilirubinemia in 59% of the moderately to very preterm infants. Thirty-eight percent were exposed to antenatal steroid therapy, 43% received nCPAP, 5.5% required mechanical ventilation, 5.2% were administered surfactant, and 30% received antibiotic therapy. The risks of neonatal diseases increased with decreasing GA, with odds ratios ranging from 2.1 to 23. Low birth weight for GA was more common at lower GA and was associated with increased risks for morbidity.Conclusions: Despite general advances in perinatal care, moderately preterm infants still face substantially increased risks for neonatal diseases, and these risks increase linearly as GA decreases. Whereas neonatal morbidity was similar to results of previous reports, management of respiratory problems was found to differ markedly from other studies.