The rate of late preterm births has been increasing over time. It has been recognized that this population is at increased risk for various morbidities as well as mortality. Late preterm infants (LPI) (those born 34 to 36 6/7 weeks gestation) comprise a unique population requiring enhanced awareness and sensitivity to issues of delivery, transition, infection, nutrition, discharge readiness, and parent education that need to begin shortly after birth.
Late preterm births comprise approximately 8000 deliveries annually in North Carolina. There is enormous variation between providers and across hospitals in the care of LPI including feeding related issues, support for breastfeeding, treatment of hyperbilirubinemia and hypoglycemia, and safe sleep counseling.
Additionally LPIs incur significant costs in initial hospitalization dealing with the above clinical issues and as a result of readmissions. Studies report readmission rates for LPIs that were 1.8 times higher than term infants. Jaundice and infection were the main reasons for readmissions especially in breast fed LPIs. Others have reported readmission rates of 5.5%, 6.9% and 5.8% for 34, 35 and 36 week infants respectively.
Via a statewide Care of the LPI collaboration, the Perinatal Quality Collaborative of North Carolina will support facility Perinatal Quality Improvement Teams to develop guidelines within NC hospitals for the Care of the Late Preterm Infant.