Menu Expand
Moderate Preterm, Late Preterm, and Early Term Births, An Issue of Clinics in Perinatology, E-Book

Moderate Preterm, Late Preterm, and Early Term Births, An Issue of Clinics in Perinatology, E-Book

Lucky Jain | Tonse N. K. Raju

(2013)

Additional Information

Abstract

This issue is expected to be in high demand, being extremely valuable to both neonatologists and maternal-fetal medicine physicians. The Guest Editors have put together a very comprehensive issue that looks at the premature infant. Topics include: Moderate Preterm. Late Preterm and Early Term Births: Epidemiology and Trends; Stillbirth Reduction Efforts and Impact on Early Births; Management of Indicated Early Term and Late Preterm Births; Physiological Underpinnings for Clinical Problems in Moderately Preterm, Late Preterm;Brain Maturation in the Second of Half of Pregnancy; Respiratory Disorders in Moderately Preterm, Late Preterm and Early Term Infants; Metabolic and Neurologic Issues in Moderately Preterm, Late Preterm and Early Term Infants; and Quality Initiatives Related to Moderately Preterm, Late Preterm and Early Term Births.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Moderate Preterm,Late Preterm andEarly Term Births i
Copyright\r ii
Contributors iii
Contents vii
Forthcoming Issues xiii
The Tug of War Between Stillbirths and Elective Early Births xv
References xviii
Late Preterm and Early Term Births xix
References xx
Epidemiology of Moderate Preterm, Late Preterm and Early Term Delivery 601
Key points 601
Introduction 601
Prevalence rates and temporal trends of moderate preterm, late preterm, and early term deliveries 602
Recurrence of moderate preterm and late preterm deliveries 603
Risk factors for moderate preterm, late preterm, and early term deliveries 606
Adverse infant outcomes associated with delivery from 32 to 38 weeks' gestation 606
Moderate Preterm Birth (32–33 Weeks) 606
Late Preterm Birth (34–36 Weeks) 606
Early Term Birth (37–38 Weeks) 607
Summary 607
References 607
Stillbirth Reduction Efforts and Impact on Early Births 611
Key points 611
Introduction 611
Implications of late preterm or early term delivery 612
Pregnancies at increased risk for stillbirth 615
Hypertension 615
Diabetes 616
Intrauterine Growth Restriction 617
Multiple Gestations 618
Placental Abnormalities 619
Fetal Abnormalities 620
Prior Stillbirth 620
Abnormal Fetal Testing 621
Knowledge gaps 621
Summary 621
References 625
Early Births and Congenital Birth Defects 629
Key points 629
Introduction and historical perspective 629
Birth defects causing early birth 630
Chromosomal Defects 631
Polyhydramnios 631
Congenital Infections 632
Early elective delivery secondary to birth defects 633
Multiple Gestation 633
Gastrointestinal Defects 635
Congenital Heart Disease 636
Growth Issues 636
Maternal conditions associated with birth defects and early birth 637
Obesity 637
Diabetes 637
Depression 638
Behavioral Factors 639
Summary 639
References 640
Physiologic Underpinnings for Clinical Problems in Moderately Preterm and Late Preterm Infants 645
Key points 645
Introduction 645
Thermoregulation 646
Respiratory morbidities 646
RDS 647
TTN 647
Hypoxic Respiratory Failure 647
Pneumonia 648
Autonomic Regulation, Control of Breathing, and Apnea of Prematurity 648
Immunologic immaturity and infections 648
Glucose homeostasis 653
Gastrointestinal immaturity and feeding 654
Hepatic immaturity and hyperbilirubinemia 655
Brain dysmaturity and risk for periventricular leukomalacia 657
Summary 658
References 658
Respiratory Disorders in Moderately Preterm, Late Preterm, and Early Term Infants 665
Key points 665
Epidemiology 665
Fetal lung development and neonatal respiratory transition 667
Respiratory morbidities 671
Long-term risk of respiratory disorders 673
Acknowledgments 674
References 674
Jaundice and Kernicterus in the Moderately Preterm Infant 679
Key points 679
Introduction 679
Scope of the problem 680
Mechanism of brain injury 681
Clinical manifestations of hyperbilirubinemia in the moderately preterm infant 682
Clinical management of hyperbilirubinemia in the moderately preterm infant 682
Future directions 685
Summary 685
Acknowledgments 685
References 685
Management of Breastfeeding During and After the Maternity Hospitalization for Late Preterm Infants 689
Key points 689
Late preterm infants and mothers: a population at risk for poor lactation outcomes 690
Suction Pressures and Milk Removal During Breastfeeding in Late Preterm Infants 691
Lactation Risk for Mothers of Late Preterm Infants 692
Late preterm infants cared for in the maternity setting should not be considered healthy term infants 693
Management of breastfeeding for late preterm infants and mothers 694
The Maternity Hospital Stay 694
Preparing for Hospital Discharge 695
Lactation Technologies Suitable for Mothers and LPIs 695
Protecting milk volume 695
Facilitating milk intake during breastfeeding 697
Ensuring adequate milk intake during breastfeeding 697
Discontinuing Lactation Technologies for Mothers and LPIs 699
Adequacy of Exclusive Human Milk for MPIs, LPIs, and ETIs 699
Summary 700
References 700
Neuropathologic Studies of the Encephalopathy of Prematurity in the Late Preterm Infant 707
Key points 707
Introduction 708
Brain development in the second half of human gestation 709
The encephalopathy of prematurity further defined 710
The encephalopathy of prematurity in the late preterm infant 711
Periventicular Leukomalacia (PVL) in the Late Preterm Infant at Autopsy 711
Reactive Gliosis and Activated Microglia in the Cerebral White Matter in EP in Late Preterm Infants at Autopsy 712
Gray Matter Lesions in EP in Late Preterm Infants at Autopsy 713
Thalamic Damage in EP in Late Preterm Infants at Autopsy 716
Deficit of Neurons in the Cerebral White Matter in EP in Late Term Infants at Autopsy 717
Summary 718
References 719
Neurologic and Metabolic Issues in Moderately Preterm, Late Preterm, and Early Term Infants 723
Key points 723
Intracranial hemorrhage 724
Periventricular leukomalacia 726
Apnea 727
Maturation of feeding ability 727
Hypoxic-ischemic encephalopathy 731
Perinatal stroke 732
Control of breathing and thermoregulation 733
Summary 734
References 734
Long-Term Outcomes of Moderately Preterm, Late Preterm, and Early Term Infants 739
Key points 739
Background 739
Maternal factors 740
Neonatal characteristics 740
Postdischarge medical problems 740
Neurodevelopmental outcome studies 741
Newborn to Preschool 741
Early School Age 744
Adolescents and Adults 746
Early term infants 748
Summary 748
References 749
Hospital Readmissions and Emergency Department Visits in Moderate Preterm, Late Preterm, and Early Term Infants 753
Key points 753
Kaiser Permanente—primary data collection 762
KPNC cohort 763
Hospital readmissions and diagnoses 763
Readmission age 766
Temporal trends in readmission rates 767
Emergency department visits and diagnoses 768
ED visit age 768
Risk factors for hospital readmissions and ED visits 769
Summary 771
References 772
Appendix\r 775
Quality Initiatives Related to Moderately Preterm, Late Preterm, and Early Term Births 777
Key points 777
Introduction 777
OPQC 778
OPQC Neonatal Initiatives 779
Reducing late-onset infections 779
Human milk 779
OPQC Obstetrics Initiatives 783
Thirty-nine weeks delivery project 783
Thirty-nine weeks delivery/birth records accuracy 783
Antenatal corticosteroids 785
Areas for future QI initiatives 785
Delaying Preterm Birth 785
Progesterone 785
Admission/Level of Care 786
Respiratory Management 786
Infection Reduction 787
Feeding Management 787
Discharge Planning 787
Summary 788
Acknowledgments 788
References 788
Moderately Preterm, Late Preterm and Early Term Infants 791
Key points 791
Introduction 791
Some aspects of developmental maturation 792
Definition and epidemiology 792
Obstetric issues 793
Neonatal issues 793
Cardiovascular and Pulmonary Systems 794
Nervous System 794
Metabolic 794
Nutrition, Breastfeeding and Lactation, and the Gastrointestinal System 794
Immunology and Sepsis 795
Renal and Genitourinary Systems 795
Development Pharmacology 795
Miscellaneous 795
Summary 795
References 796
Index 799