title: Short-term respiratory outcomes in late preterm infants.
abstract: OBJECTIVE
  To evaluate short-term respiratory outcomes in late preterm infants (LPI) compared with those of term infants (TI).
  
  
  METHODS
  A retrospective study conducted in a single third level Italian centre (2005-2009) to analyse the incidence and risk factors of composite respiratory morbidity (CRM), the need for adjunctive therapies (surfactant therapy, inhaled nitric oxide, pleural drainage), the highest level of respiratory support (mechanical ventilation - MV, nasal continuous positive airway pressure--N-CPAP, nasal oxygen) and the duration of pressure support (hours in N-CPAP and/or MV).
  
  
  RESULTS
  During the study period 14,515 infants were delivered. There were 856 (5.9%) LPI and 12,948 (89.2%) TI. CRM affected 105 LPI (12.4%), and 121 TI (0.9%), with an overall rate of 1.6%. Eighty-four LPI (9.8%) and 73 TI (0.56%) received respiratory support, of which 13 LPI (1.5%) and 16 TI (0.12%) were ventilated. The adjusted OR for developing CRM significantly increased from 3.3 (95% CI 2.0-5.5) at 37 weeks to 40.8 (95% CI 19.7-84.9%) at 34 weeks. The adjusted OR for the need of MV significantly increased from 3.4 (95% CI 1.2-10) at 37 weeks to 34.4 (95% CI 6.7-180.6%) at 34 weeks. Median duration of pressure support was significantly higher at 37 weeks (66.6 h vs 40.5 h). Twin pregnancies were related to a higher risk of CRM (OR 4.3, 95% CI 2.6-7.3), but not independent of gestational age (GA). Cesarean section (CS) was associated with higher risk of CRM independently of GA, but the OR was lower in CS with labour (2.2, 95% CI 1.4-3.4 vs 3.0, 95% CI 2.1-4.2).
  
  
  CONCLUSIONS
  In this single third level care study late preterm births, pulmonary diseases and supportive respiratory interventions were lower than previously documented. LPI are at a higher risk of developing pulmonary disease than TI. Infants born from elective cesarean sections, late preterm twins in particular and 37 weekers too might benefit from preventive intervention.
authors.forename: Miria
authors.initials: M
authors.lastname: Natile
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Ventura
authors.forename: Marco
authors.initials: M
authors.lastname: Colombo
authors.forename: Davide
authors.initials: D
authors.lastname: Bernasconi
authors.forename: Anna
authors.initials: A
authors.lastname: Locatelli
authors.forename: Cristina
authors.initials: C
authors.lastname: Plevani
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Valsecchi
authors.affiliation: Neonatology and Neonatal Intensive Care Unit, MBBM Foundation, via Pergolesi 33, 20900 Monza, Italy. p.tagliabue@hsgerardo.com.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tagliabue
mesh_terms: D000328:Adult; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000628:therapy*; D007558:Italy / Q000453:epidemiology; D008297:Male; D009017:Morbidity / Q000639:trends; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D011247:Pregnancy; D011379:Prognosis; D012124:Respiratory Care Units; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors