Late preterm births: Epidemiology, possible causes, and consequences.

Late preterm births have been on the increase. Though the reasons for the increase in late preterm births are unclear, non-medically indicated inductions and cesarean sections seem to be the significant preventable contributors. Late preterm infants are typically healthier than very preterm infants, but compared to term infants they are at significantly increased risk of both short and long term morbidity and mortality. In the short term they have increased rates of feeding difficulties, hypoglycemia, jaundice, temperature instability, apnea, respiratory distress and sepsis evaluation compared to term infants. Emerging data also suggest a higher rate of long-term neurodevelopmental, social, and medical morbidity. Therefore, if elective induction of labor or cesarean section at late preterm gestation (34-36 weeks of gestational age) is considered for either maternal or fetal indications, the risk and benefits should be carefully examined. The family and physician should discuss that elective delivery of late preterm infants is not recommended unless absolutely indicated. Due to a considerably higher risk of morbidity and mortality, developing and testing new paradigms of obstetric and fetal management for pregnancies with potential for late preterm delivery are a logical objective. For example, strategies to enhance fetal physiologic maturation when late preterm delivery is unavoidable need to be explored. [ABSTRACT FROM AUTHOR]