Current practices could lead to serious public health problems
While late preterm deliveries have become more common in the industrialized world, the long-term consequences on the health of newborns are still not well understood. Recent evidence indicates that these consequences are far from negligible, according to an editorial by Dr. Michael Kramer of McGill University and the Research Institute of the Montreal Children’s Hospital at the MUHC, published in The Journal of Pediatrics last week.
Late preterm babies, or those born between 34 and 36 completed weeks of gestation, suffer from fewer problems than early preterm babies (those born before 34 weeks of gestation). Late preterm babies face three times the risk of developing cerebral palsy, and a slightly higher risk of developmental delay than full term babies. “Although the absolute risks are low for individual babies, they could become a public health problem because of the growing number of these births in the general population,” Kramer explained.
Two main factors have contributed to this trend: the rise in induced preterm deliveries (due to problems with the mother or the fetus) and infertility treatments. Both in-vitro fertilization (IVF) techniques with transfer of multiple embryos, which is common with IVF treatment, and ovarian stimulation often result in twin or higher-order multiple births (triplets, quadruplets). More than half of all twins and virtually all higher-order multiples are born preterm.
Further study is required to determine when doctors should induce labour and when they should avoid this measure. “Ideally, obstetricians and pediatricians should inform future mothers about the potential health risks associated with late preterm delivery,” said Dr. Kramer. “The risks must be carefully weighed before a decision is made that could have serious consequences on the newborn.”