Near-Term Babies May Face Higher Risk of Problems




Article Courtesy of The New York Times
By RONI CARYN RABIN

Babies born just three to six weeks before their due dates are more likely than full-term babies to have disabilities or developmental delays in kindergarten, a study has found. The children also are slightly more likely to be suspended or held back in kindergarten and to require special education.

Over all, the risk is small, and doctors emphasized that parents should not be alarmed. While almost 3 percent of full-term babies in the study had a developmental delay or disability in kindergarten, just more than 4 percent of the late-preterm babies did. Still, that amounts to a 36 percent increase in risk.

Researchers said they were surprised by the results, in large part because babies born after 34 or 35 weeks of gestation, though not full-term, have long been considered in the clear.

“The biggest take-home point is that the late-preterm baby is not exactly the same as the term baby,” said Dr. Steven Benjamin Morse, an author of the study and an associate professor of pediatrics at University of Florida.

“They go home from the hospital in two to three days, and they look great, and they act like full-term babies,” he said. “But now we’ve found that they do have some increased risk of problems when they enter school. We were surprised.”

The study is in the April issue of the journal Pediatrics.

Researchers tracked the development of healthy single babies born in Florida between Jan. 1, 1996, and Aug. 31, 1997. They compared 7,152 babies born after 34 weeks but before 37 weeks of pregnancy with 152,661 babies born after 37 weeks.

They found that the risk for a developmental delay or disability was 36 percent higher among the late-preterm infants, compared with those born at term, while the risk for suspension in kindergarten was 19 percent higher.

The late-preterm babies were at a 10 percent to 13 percent increased risk for four other developmental problems, including diagnoses of a disability at age 3 or 4, requiring special education services or being kept back in kindergarten.

Although the problems affect only a fraction of babies, preterm births are on the rise in the United States and have increased to 12.3 percent in 2003, from 9.4 percent of all live births in 1981. The vast majority of preterm births, about 70 percent, are in this late-preterm category.

Though many preterm deliveries are medically necessary, some may be preventable, said Dr. Alan Fleischman, medical director of the March of Dimes. “We need to make sure the obstetricians are not suggesting early deliveries and Caesarean sections to be done at their convenience, and that the mothers are not requesting early deliveries,” Dr. Fleischman said.