Article information
Abstract
Objective
this study aimed to review the literature regarding late preterm births (34 weeks to 36 weeks and 6 days of gestation) in its several aspects.
Sourcesthe MEDLINE, LILACS, and Cochrane Library databases were searched, and the references of the articles retrieved were also used, with no limit of time.
Data synthesisnumerous studies showed a recent increase in late preterm births. In all series, late preterm comprised the majority of preterm births. Studies including millions of births showed a strong association between late preterm birth and neonatal mortality. A higher mortality in childhood and among young adults was also observed. Many studies found an association with several neonatal complications, and also with long-term disorders and sequelae: breast-feeding problems, cerebral palsy, asthma in childhood, poor school performance, schizophrenia, and young adult diabetes. Some authors propose strategies to reduce late preterm birth, or to improve neonatal outcome: use of antenatal corticosteroids, changes in some of the guidelines for early delivery in high-risk pregnancies, and changes in neonatal care for this group.
Conclusionsnumerous studies show greater mortality and morbidity in late preterm infants compared with term infants, in addition to long-term disorders. More recent studies evaluated strategies to improve the outcomes of these neonates. Further studies on these strategies are needed.
Keywords:
Preterm labor
Early neonatal mortality
Neonatal mortality
Infant mortality
High-risk pregnancy
Resumo
Objetivo
revisar a literatura sobre prematuridade tardia (nascimentos de 34 semanas a 36 semanas e seis dias) em seus vários aspectos.
Fonte dos dadosbuscas nas bases MEDLINE, LILACS e Biblioteca Cochrane, sem limite de tempo, e nas referências bibliográficas dos artigos encontrados.
Síntese dos dadosmuitos estudos mostram aumento na taxa de prematuridade tardia nos últimos anos. Em todas as séries, os prematuros tardios correspondem à maioria dos nascimentos prematuros. Estudos envolvendo análises de milhões de nascimentos com- provam a forte associação entre prematuridade tardia e mortalidade neonatal. Também se observou associação com maior mortalidade infantil e no adulto jovem. Muitos estu- dos encontraram associação com várias complicações neonatais e com problemas e sequelas de longo prazo, tais como: dificuldades na amamentação, paralisia cerebral, asma na infância, pior desempenho escolar, esquizofrenia e diabetes no adulto jovem. Alguns autores propõem estratégias para reduzir a incidência desses nascimentos ou para melhorar seus resultados: utilização de corticosteroides ante natais; mudança em rotinas de interrupção de gestações de alto risco; mudanças nos cuidados neonatais.
Conclusõesmuitos estudos mostram maior morbidade e mortalidade nos prematuros tardios comparados aos recém-nascidos a termo, além de sequelas e complicações de longo prazo. Estudos mais recentes avaliam estratégias para melhorar o prognóstico destes recém-nascidos. Novos estudos com este objetivo são bem-vindos.
Palavras-chave:
Trabalho de partoprematuro
Mortalidade neonatal precoce
Mortalidade neonatal
Mortalidade infantil
Gravidez de alto risco
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Como citar este artigo: Machado LC Jr, Passini R Jr, Rosa IR. Late prematurity: a systematic review. J Pediatr (Rio J). 2014;90:221-31.
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