Raju Tonse N K, Higgins Rosemary D, Stark Ann R, Leveno Kenneth J
National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA.
Pediatrics. 2006 Sep;118(3):1207-14. doi: 10.1542/peds.2006-0018.
In 2003, 12.3% of births in the United States were preterm (< 37 completed weeks of gestation). This represents a 31% increase in the preterm birth rate since 1981. The largest contribution to this increase was from births between 34 and 36 completed weeks of gestation (often called the "near term" but referred to as "late preterm" in this article). Compared with term infants, late-preterm infants have higher frequencies of respiratory distress, temperature instability, hypoglycemia, kernicterus, apnea, seizures, and feeding problems, as well as higher rates of rehospitalization. However, the magnitude of these morbidities at the national level and their public health impact have not been well studied. To address these issues, the National Institute of Child Health and Human Development of the National Institutes of Health invited a multidisciplinary team of experts to a workshop in July 2005 entitled "Optimizing Care and Outcome of the Near-Term Pregnancy and the Near-Term Newborn Infant." The participants discussed the definition and terminology, epidemiology, etiology, biology of maturation, clinical care, surveillance, and public health aspects of late-preterm infants. Knowledge gaps were identified, and research priorities were listed. This article provides a summary of the meeting.
2003年,美国12.3%的婴儿为早产(妊娠不足37周)。这表明自1981年以来早产率上升了31%。这种增长的最大贡献来自妊娠34至36周之间的分娩(通常称为“接近足月”,但本文称为“晚期早产”)。与足月儿相比,晚期早产儿出现呼吸窘迫、体温不稳定、低血糖、核黄疸、呼吸暂停、惊厥和喂养问题的频率更高,再次住院率也更高。然而,这些发病率在国家层面的严重程度及其对公共卫生的影响尚未得到充分研究。为了解决这些问题,美国国立卫生研究院国家儿童健康与人类发展研究所于2005年7月邀请了一个多学科专家团队参加题为“优化近足月妊娠和近足月新生儿的护理与结局”的研讨会。与会者讨论了晚期早产儿的定义和术语、流行病学、病因、成熟生物学、临床护理、监测及公共卫生方面的问题。确定了知识空白,并列出了研究重点。本文对会议内容进行了总结。