Babies Born Before 37 Weeks Not as Healthy

Respiratory Distress, Jaundice, Low Blood Sugar More Common

From the WebMD Archives

Aug. 2, 2004 -- Babies born one or two weeks early are generally believed to be as healthy as full-term infants, but new research shows this is often not the case.

When compared with newborns delivered at 37 weeks and beyond, delivery at 35 or 36 weeks was linked to more serious medical problems and higher hospital costs. This is one of the first studies to examine health issues associated with near-term birth.

Specifically, the near-term newborns were far more likely than full-term infants to develop early respiratory problems, jaundice, and low blood sugar and have difficulty maintaining a normal body temperature. Researchers from Boston's MassGeneral Hospital for Children say their findings suggest that even though these babies may look as healthy as full-term infants, they are more likely to have certain medical problems.

"There is a conventional wisdom that babies born close to term are clinically the same as full-term newborns, and up until now there has been little in the literature to support or counter this idea," lead researcher Marvin L. Wang, MD, tells WebMD.

Too Posh to Push

Wang says the findings have implications for women who choose to have their babies delivered before their due dates by elective C-section for reasons of convenience or because they perceive surgical delivery as less damaging to their bodies.

Early, planned C-section is reported to be a growing trend among Hollywood celebrities -- and this trend has even spread to other areas of the country. Known as "too posh to push," the term is based on news reports claiming that ex-Spice Girl Victoria Beckham had her babies this way.

"There can be valid medical reasons for delivering early, but our study calls into question the presumption that elective delivery at 35 or 36 weeks poses no risk to the infant," Wang says.

In his role as co-director of the newborn nurseries at Massachusetts General, Wang says he routinely saw more post-delivery health problems among near-term infants than among those born at 37 weeks or more, but he was surprised to find that few researchers had studied this newborn population.

Wang and colleagues examined the records of infants born at the hospital over a three-year period and randomly selected 95 full-term infants, born at 37 weeks or more, and 90 near-term infants, born at 35 or 36 weeks..

Near-Terms 'Masquerade' as Term

Both near-term and full-term babies had similar Apgar scores -- measurements and observations made at birth to determine a newborn's health. In addition, both groups of babies had similar post-delivery hospital stays. However, nearly all other measured clinical outcomes differed significantly between the near-term and full-term newborns.

Overall, 78% of near-term babies were diagnosed with some medical problem, compared with 45% of full-term infants. Hospital costs averaged $2,600 more for the near-term infants as a result.

Nearly 30% of the near-term infants had clinical evidence of respiratory distress, compared with closer to 5% of the full-term newborns. And just over 50% developed jaundice, compared with just under 40% of full-term babies.

The researchers concluded that near-term infants "masquerade" as term infants because they look more like healthy babies than preemies.

Neonatal specialist David Adamkin, MD, says problems such as difficulty feeding, jaundice, and temperature regulation are commonly seen among infants born in this 35 and 36 week gray area.

"These babies are often around six pounds. Since they are a healthy weight, that leads to the assumption that they are healthy," says Adamkin, who is director of the division of neonatal medicine at Louisville's Kosair Children's Hospital. "But they are not the same as full-term infants from a maturation standpoint. They have their own set of health issues."

Show Sources

SOURCES: Wang, M. Pediatrics, Aug. 2, 2004; vol 114. Marvin L. Wang, MD, co-director, newborn nurseries, MassGeneral Hospital for Children, Boston. David Adamkin, MD, director, division of neonatal medicine, director of nurseries, Kosair Children's Hospital, Norton Hospital Women's Pavilion, Louisville, Ky. American Academy of Pediatrics.
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