The clinical outcomes of late preterm infants: a multi-center survey of Zhejiang, China.

OBJECTIVE To explore birth rate, delivery mode, medical problems, requirement of respiratory support, and acute outcomes of late preterm infants in Zhejiang province in eastern China. METHODS Eleven tertiary hospitals were recruited. Clinical data of every nursery admission from January to December 2007 were collected and analyzed. RESULTS During the study period, 44,362 infants were born with an overall preterm birth rate of 8.9%, and late preterm birth rate of 6.2%. Late preterm infants had higher cesarean section rate than the whole population (64.9% vs. 58.2%). One-fifth of the nursery admissions were late preterm infants, of whom, 63.8% were delivered by cesarean section. Respiratory distress (42.1%) was the most common medical problem of late preterm infants. Hyperbilirubinemia (17.6%), hypoglycemia (8.7%) and sepsis (5.9%) were also common. The first three primary diagnoses of respiratory distress included pneumonia (39.5%), transient tachypnea of newborn (TTN) (22.5%) and respiratory distress syndrome (RDS) (19.0%). Compared with term infants, late preterm infants with respiratory distress needed more respiratory support with nasal continuous positive airway pressure (nCPAP) (21.4% vs. 11.6%) or with a mechanical ventilator (15.4% vs. 11.0%), and also had higher in-hospital mortality (0.8% vs. 0.4%). CONCLUSIONS Late preterm infants are associated with very high cesarean section rate and have more medical problems and poorer short-term outcomes than term infants in China.