Late Preterm and Early Term Birth: At-risk Populations and Targets for Reducing Such Early Births

Abstract

The risks of late preterm (LPT) and early term (ET) birth have been recognized during the last decade. Increased awareness accompanied by efforts to reduce elective delivery before 39 weeks of gestation have led to a decline in LPT/ET births. Despite this success, strategies to identify and reduce preventable LPT/ET births using traditional and novel prevention methods are still needed. Because preterm birth is a common endpoint associated with many different preventable and nonpreventable causes, the efforts for reducing such early births must be multifaceted. For neonates born LPT/ET, there is an inverse relationship between gestational age and morbidity and mortality, with a nadir at 39 to 40 weeks of gestation. Recognition of the short-term complications of LPT/ET is important for timing of delivery and the initial clinical management of these patients. In addition, the recognition of the long-term respiratory and neurocognitive complications of LPT/ET birth helps inform the evaluation, treatment, and monitoring for impairments and disabilities that benefit from early detection and intervention. In this article, we review the definition of LPT/ET birth, prevention strategies, indications for LPT/ET birth, and the short- and long-term outcomes for such infants.