Near-Term Birth Takes Its Toll

Thinking about having labor induced or scheduling a Cesarean section a few weeks before your due date? You might want to do some research before making that decision.

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Thinking about having labor induced or scheduling a Cesarean section a few weeks before your due date? You might want to do some research before making that decision. "Near-term" babies, those born between 35 and 37 weeks gestation, have been the focus of increasing attention over the past few years. According to a 2004 Pediatrics study, near-term babies have a higher incidence of jaundice, low blood sugar, respiratory problems, difficulty maintaining body temperature and other problems.

"Conventional wisdom has been that babies who were near-term would do as well as full-term babies. They stay in the normal nursery and usually go home when the mother is discharged," says lead study author Marvin Wang, M.D., director of the newborn nurseries at Massachusetts General Hospital for Children in Boston. But of 95 full-term and 90 near-term infants in the study, none of the full-term babies had multiple problems while 18 of the near-term babies did.

It's an important distinction to make; for some diagnoses, treatment is different for term and preterm infants. "For example, respiratory distress usually signals infection in term infants; but in premature infants, it is more likely to be caused by lung immaturity," Wang says. "Our results suggest we need to carefully examine how to treat children who are in between those two categories." The results also impact the current trend of scheduling deliveries. "Our study calls into question the presumption that elective Cesarean section at 35 or 36 weeks poses no risk to the infant," Wang says.

According to the Association of Women's Health, Obstetric and Neonatal Nurses, here are some of the questions parents of near-term babies need to ask: 1) How often should I bring my baby in for exams? 2) What is the minimum number of times I should feed him each day? 3) What is the longest period I should let my baby go without eating? 4) What should I be looking for in terms of his behavior or appearance? 5) How will I know if I should call the doctor, and how do I reach him?

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