Nurses and other clinicians can help improve outcomes for late-preterm infants with various inexpensive interventions, according to a statement from the Association of Womens Health Obstetric and Neonatal Nurses.
Such interventions may include kangaroo care, or holding the infant in skin-to-skin contact on the parents chest; helping moms breast-feed within the first hour of life; assessing vital signs frequently; and avoiding early bathing.
Womens health professionals also should prepare parents before hospital discharge to recognize the signs and symptoms of potential risks in their infants and to understand their special care needs.
More than 400,000 late-preterm infants — born between 34 and 36 weeks gestation — are born to American women each year, according to the AWHONN. Compared with full-term infants, late-preterm infants experience more medical complications after birth, such as respiratory distress, temperature instability, hypoglycemia, jaundice, inadequate feeding and a variety of infections.
Late-preterm infants comprise 71% of all premature infants born each year, according to the AWHONN. Despite the fact that many appear similar to full-term newborns, they do not have the same physiologic maturity and thus are at risk for morbidity and mortality during the neonatal period and through the first year of life. These newborns require increased surveillance and special care both in the hospital and after discharge to prevent serious complications.
The AWHONN conducted a 14-hospital research-based practice project on late-preterm infants. The researchers found that 36% of late-preterm infants initially were cared for in a special care nursery, with about half of that group eventually transferred to a well-baby nursery. Of the 64% of late-preterm infants initially cared for in a routine nursery, 10% were transferred to a special care unit or NICU.
More than half of late-preterm infants experienced hypothermia, hypoglycemia, feeding difficulties, hyperbilirubinemia or respiratory distress, and/or needed a septic workup. The risk for these problems was higher in infants of younger gestational ages.
Of the infants in the study, 32% were bathed during the first two hours of life and more than two-thirds within their first four hours. Meanwhile, 52% received kangaroo care during the first 48 hours of life.
Full results of the project appear in the September/October issue of the Journal of Obstetric, Gynecologic & Neonatal Nursing. The abstract of the study is available at http://onlinelibrary.wiley.com/doi/10.1111/j.1552-6909.2012.01401.x/abstract.