A new disease—the late preterm infant

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Pediatricians recognize the considerable risks for the poor developmental outcomes for very preterm infants. However, the majority of infants born preterm are between 32 and 36 weeks gestation. Most of these infants have few acute problems and are discharged from nurseries with the Good Housekeeping stamp of approval as normal. There have been recent concerns about short-term morbidities, particularly in relation to late preterm cesarean section deliveries. The other lingering concern is that these infants may not be normal. After all, they did deliver preterm for some reason, which is generally not identified. In this issue of The Journal, Chyi et al provide us with school age outcomes to grade 5 for infants born at 32-36 weeks gestation. The late preterms had lower math and reading skills and more need for special education than did comparison full-term infants. The causes of late preterm labor are not understood, nor are there prevention strategies to decrease late preterm deliveries or to improve the outcomes for these infants. The multiple problems with and questions about the late preterm infant are summarized in the accompanying editorial by Jain. These late preterm infants represent over 10% of all deliveries in the US and are generally called normal, but they are not.