Children born between 34 weeks and 37 weeks are more likely to have severe respiratory illness than are full-term infants, according to a study in the July 28 issue of JAMA, and this risk decreases with each added week of gestational age.

For the study, investigators analyzed 233,844 deliveries between 2002 and 2008 in 19 hospitals across the United States. Charts were abstracted for all neonates with respiratory problems admitted to a NICU, and late preterm births were compared with term births in regard to resuscitation, respiratory support, and respiratory diagnoses.

Among late preterm births, 36.5% were admitted to a NICU and 10.5% had respiratory compromise. In term infants, 7.2% were admitted to a NICU and just greater than 1% had respiratory illness. The researchers found respiratory distress syndrome (RDS) to be the most common respiratory illness, followed by transient tachypnea, then pneumonia and respiratory failure.

The authors note that much of the supporting data for these conclusions are derived from studies that are more than a decade old, are from outside the United States, and were drawn from small populations; they recommend that future studies “should focus on indications for late preterm birth. Only by more completely understanding reasons for rising rates of late preterm birth might clinicians be able to initiate salutary interventions to decrease neonatal respiratory morbidity."
 

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