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November 2013

Not All “Term” Infants Are Created Equal

Author Affiliations
  • 1Department of Pediatrics, Women and Infants’ Hospital, Providence, Rhode Island
  • 2Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
JAMA Pediatr. 2013;167(11):1001-1002. doi:10.1001/jamapediatrics.2013.2593

During the 1980s, an ill-defined group of infants was being labeled as “near term,” implying that they were “almost term” and, hence, one had no reasons for concern. However, an expert panel convened by the Eunice Kennedy Shriver National Institute of Child Health and Human Development in 2005 reviewed the then available literature and concluded that a simple, if convenient, dichotomous division at any gestational age is fraught with risk because maturation is a continuum.1 The gestational age breakdown, although convenient for epidemiological classification, is not always appropriate for clinical management. The panel suggested that the phrase near term should be replaced with late preterm to convey that infants born between 34 and 36 weeks of gestation are immature and vulnerable, needing close monitoring, evaluation, and follow-up examination. Since then, more than 200 publications on late-preterm births have confirmed that late-preterm infants indeed have higher rates of readmissions, postneonatal mortality, sudden infant death syndrome, white matter injury, and neurodevelopmental problems well into school age.2,3

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