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Improving birth outcomes in premature babies. 
Late preterm infants: birth outcomes and healthcare utilization in the first year.

Background. Late preterm infants are born 4 to 6 weeks early. They are very common and comprise 12% of all births in the U.S. To the casual observer, they are very similar to term infants, but they are at risk for worse outcomes because they are immature. They have feeding problems, difficulties with yellow jaundice, difficulties with low blood sugar, and respiratory difficulties. More importantly, most studies have shown they are at an increased risk of death both before and after discharge from the nursery. Further, there are many obstetrical decisions during the final weeks of pregnancy that involve the risks and benefits of delivering a baby early versus the risks of delaying delivery. Most studies to date, however, have been unable to separate the effects of delivering early and the effects of congenital anomalies and obstetrical complications that lead to early delivery.

Advance. This study used a novel statistical method called propensity scoring to clearly separate the effects of early delivery itself from other factors such as obstetrical complications and congenital anomalies. When these other factors were taken into account, the effects of late preterm delivery itself were much less marked. For example, one study found a 44 fold increase in death in babies born 4 - 6 weeks early, while this study found only a slight, almost insignificant increase in death in this population when all other factors are taken into account.

Grant Support. This study was supported by the NCRR COBRE P20 RR20146, Arkansas Children's Hospital Research Institute, and the Tobacco Settlement Proceeds Act of 2000. COBRE funds allowed protected time and data analysis for one of the authors who contributed to the interpretation of data.  

Public Health Impact/Significance. This study will allow obstetricians to make better informed decisions regarding when to intervene in the last few weeks of pregnancy. 

Institution and State. This work was preformed at the Arkansas Children's Hospital Research Institute and the University of Arkansas for Medical Sciences in Arkansas.

Link to article. http://www.ncbi.nlm.nih.gov/pubmed/20603259

Late Preterm Infants: Birth Outcomes and Health Care Utilization in the First Year. Bird TM, Bronstein JM, Hall RW, Lowery CL, Nugent R, Mays GP.Departments of Pediatrics. Pediatrics. 2010 Jul 5. [Epub ahead of print]

 Video. The attached story aired on a local TV channel.