The near-term or late preterm infant: Every week counts

November 1, 2007

Editorial about the dearth of research devoted to the needs of infants born 34 and 37 weeks.

Key Points

The NICU (neonatal intensive care unit) has become the focus for education and training of pediatricians about the special needs of newborns delivered prematurely. The term nursery is the place to learn about the examination of the well newborn and about counseling new parents in their care. An article in this month's issue reviews management for the new born that is neither premature nor "term."

Dr. Hubbard, Dr. Stellwagen, and PNP Wolf remind us that newborn infants are not completely equipped for life outside the uterus, even when they are mature and stable enough that they do not require intensive care. Of particular interest is the authors' attention to the deficiency of research devoted to the needs of infants born between 34 and 37 weeks gestation-infants that may be regarded by their parents as healthy and mature enough to treat as if they were born at term, but in fact demonstrate great variability in their ability to adapt to the demands of extrauterine life.

Is it appropriate for the 35-week gestation infant to "room in" with Mom? What's a safe total serum bilirubin concentration at discharge for the 36-week newborn? Are near-term infants more susceptible to infection than they would have been if they had been born at 39 or 40 weeks? What's the best method for determining whether it's safe to send the 34-week gestation infant home in a car seat? Finally, and most intriguing, how does the answer to these questions change when the infant is born at 36 weeks rather than 34 weeks gestation?