Differences in mortality between late-preterm and term singleton infants in the United States, 1995-2002

J Pediatr. 2007 Nov;151(5):450-6, 456.e1. doi: 10.1016/j.jpeds.2007.05.002. Epub 2007 Jul 24.

Abstract

Objective: To assess differences in mortality between late-preterm (34-36 weeks) and term (37-41 weeks) infants.

Study design: We used US period-linked birth/infant death files for 1995 to 2002 to compare overall and cause-specific early-neonatal, late-neonatal, postneonatal, and infant mortality rates between singleton late-preterm infants and term infants.

Results: Significant declines in mortality rates were observed for late-preterm and term infants at all age-at-death categories, except the late-neonatal period. Despite the decline in rates since 1995, infant mortality rates in 2002 were 3 times higher in late-preterm infants than term infants (7.9 versus 2.4 deaths per 1000 live births); early, late, and postneonatal rates were 6, 3, and 2 times higher, respectively. During infancy, late-preterm infants were approximately 4 times more likely than term infants to die of congenital malformations (leading cause), newborn bacterial sepsis, and complications of placenta, cord, and membranes. Early-neonatal cause-specific mortality rates were most disparate, especially deaths caused by atelectasis, maternal complications of pregnancy, and congenital malformations.

Conclusions: Late-preterm infants have higher mortality rates than term infants throughout infancy. Our findings may be used to guide obstetrical and pediatric decision-making.

MeSH terms

  • Asphyxia Neonatorum / mortality
  • Birth Certificates
  • Cause of Death / trends
  • Congenital Abnormalities / mortality
  • Death Certificates
  • Enterocolitis, Necrotizing / mortality
  • Female
  • Gestational Age*
  • Humans
  • Hydrops Fetalis / mortality
  • Hypoxia / mortality
  • Infant
  • Infant Mortality / trends*
  • Infant, Newborn
  • Infant, Premature*
  • Influenza, Human / mortality
  • Pneumonia / mortality
  • Pregnancy
  • Pregnancy Complications / mortality
  • Pulmonary Atelectasis / mortality
  • Respiratory Distress Syndrome, Newborn / mortality
  • Sepsis / mortality
  • Sudden Infant Death / epidemiology
  • Time Factors
  • United States / epidemiology