Mally Pradeep V, Bailey Sean, Hendricks-Muñoz Karen D
Department of Pediatrics, New York University School of Medicine, New York, NY, USA.
Curr Probl Pediatr Adolesc Health Care. 2010 Oct;40(9):218-33. doi: 10.1016/j.cppeds.2010.07.005.
Prematurity is defined as birth before 37 weeks of gestation and is the major determinant of morbidity and mortality in newborns. The gestational ages known as near term or late preterm represent about 75% of preterm births and are the fastest growing subgroups of premature infants. These infants range in gestational age from 34 0/7 to 36 6/7 weeks and are at greater risk of morbidity, such as respiratory complications, temperature instability, hypoglycemia, kernicterus, feeding problems, neonatal intensive care unit admissions, and adverse neurological sequelae when compared with term infants. Long-term neurological and school-age outcomes of late preterm infants are concerns of major public health importance because even a minor increase in the rate of neurological disability and scholastic failure in this group can have a huge impact on the health care and educational systems. There is an urgent need to educate health care providers and parents about the vulnerability of late preterm infants, who are in need of diligent monitoring and care during the initial hospital stay and a comprehensive follow-up plan for post neonatal and long-term evaluations. Clinicians involved in the day-to-day care of late preterm infants, as well as those developing guidelines and recommendations, would benefit from having a clear understanding of the potential differences in risks faced by these infants, compared with their more mature counterparts.
早产被定义为妊娠37周前出生，是新生儿发病和死亡的主要决定因素。被称为近足月或晚期早产的胎龄约占早产的75%，是早产儿中增长最快的亚组。这些婴儿的胎龄在34⁰/₇至36⁶/₇周之间，与足月儿相比，他们患呼吸系统并发症、体温不稳定、低血糖、核黄疸、喂养问题、新生儿重症监护病房收治以及不良神经后遗症等疾病的风险更高。晚期早产儿的长期神经和学龄期结局是重大公共卫生问题，因为即使该群体的神经残疾和学业失败率略有上升，也会对医疗保健和教育系统产生巨大影响。迫切需要对医疗保健提供者和家长进行教育，让他们了解晚期早产儿的脆弱性，这些婴儿在住院初期需要密切监测和护理，并需要一个全面的新生儿期后和长期评估随访计划。参与晚期早产儿日常护理的临床医生以及制定指南和建议的医生，若能清楚了解这些婴儿与更成熟婴儿相比所面临的潜在风险差异，将有所裨益。
