Evaluation and Management of the Late Preterm Infant

  • Stephen A. PearlmanEmail author
  • Kaitlin Kenaley


Late preterm infants, commonly defined as 34 0/7 to 36 6/7 weeks of gestation, have an underappreciated risk of increased morbidity and mortality when compared to their full-term counterparts. This population accounts for almost three quarters of all preterm births and has increased over the past 25 years. Although generally not as sick as earlier preterm infants, late preterm infants may present with significant respiratory morbidity, jaundice, feeding difficulties, temperature instability, hypoglycemia, infection, and apnea. These complications may lead to an increased initial length of hospital stay and a higher rate of readmission. In addition to an increased mortality rate, survivors are at increased risk for long-term adverse neurodevelopmental outcomes.


Late preterm Respiratory distress Jaundice Hypoglycemia Readmission Length of stay Neurodevelopment Neonatal mortality 


  1. 1.
    Engle WA, Tomashek KM, Wallman C. “Late-preterm” infants: a population at risk. Pediatrics. 2007;120:1390–401.CrossRefGoogle Scholar
  2. 2.
    Raju TNK. The “late preterm” birth – ten years later. Pediatrics. 2017;139:1–4.CrossRefGoogle Scholar
  3. 3.
    Leone A, Ersfeld P, Adams M, Meyer Schiffer P, Bucher HO, Arlettaz R. Neonatal morbidity in singleton late preterm infants compared with full-term infants. Acta Pediatr. 2012;101:e6–10.CrossRefGoogle Scholar
  4. 4.
    Chi C. Hypertensive disorders of pregnancy. In: Singh K, editor. Integrated approach to obstetrics and gynecology. World Scientific, New Jersey; 2016. p. 317–328.CrossRefGoogle Scholar
  5. 5.
    Gyamfi-Bannerman C, Thom EA, Blackwell SC, Tita ATN, Reddy UM, Saade GR, et al. Antenatal betamethasone for women at risk for late preterm delivery. N Engl J Med. 2016;374:1311–20.CrossRefGoogle Scholar
  6. 6.
    The American College of Obstetrics and Gynecology Committee on Obstetric Practice. Medically indicated late preterm and early-term deliveries. Committee opinion 560. Washington, DC: ACOG; 2013 (reaffirmed 2017). p. 1–3.Google Scholar
  7. 7.
    Mac Bird T, Bronstein JM, Hall RW, Lowery CL, Nugent R, Mays GP. Late preterm infants: birth outcomes and health care utilization in the first year. Pediatrics. 2010;126:e311–9.CrossRefGoogle Scholar
  8. 8.
    Eidelman AI, Schanler RJ. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827–41.CrossRefGoogle Scholar
  9. 9.
    Watchko JW. Hyperbilirubinemia and bilirubin toxicity in the late preterm infant. Clin Perinatol. 2006;33:839–52.CrossRefGoogle Scholar
  10. 10.
    Kuzniewicz MW, Parker SJ, Schnake-Mahl A, Escobar GJ. Hospital readmissions and emergency department visits in moderate preterm, late preterm, and early term infants. Clin Perinatol. 2013;40:753–75.CrossRefGoogle Scholar
  11. 11.
    Teune MJ, Bakhuizen S, Gyamfi-Bannerman C, Opmeer BG, vanKaam AH, van Wassenaer AG, et al. A systematic review of severe morbidity in infants born late preterm. Am J Obstet Gynecol. 2011;205:374.e1–9.CrossRefGoogle Scholar
  12. 12.
    Adamkin DH. Clinical report – postnatal glucose homeostasis in late-preterm and term infants. Pediatrics. 2011;127:575–9.CrossRefGoogle Scholar
  13. 13.
    Coffman S. Late preterm infants and risk for RSV. MCN. 2009;34:378–84.Google Scholar
  14. 14.
    Phillips RM, Goldstein M, Hougland K, Nandyal R, Pizzica A, Santo-Donato A, et al. Multidisciplinary guidelines for the care of late preterm infants. J Perinatol. 2013;33:S5–S22.CrossRefGoogle Scholar
  15. 15.
    McGowan JE, Alderice FA, Holmes VA, Johnston L. Early childhood development of late-preterm infants: a systematic review. Pediatrics. 2011;127:1111–24.CrossRefGoogle Scholar
  16. 16.
    Woythaler MA, McCormick MG, Smith VG. Late preterm infants have worse 24-month neurodevelopmental outcomes than term infants. Pediatrics. 2011;127:e622–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of NeonatologyChristiana Care Health SystemNewarkUSA
  2. 2.Sidney Kimmel College of Medicine of Thomas Jefferson UniversityPhiladelphiaUSA

Personalised recommendations