Near-Term Babies Face Unique Problems

Added risks -- and extra costs -- accompany early delivery

Just several extra weeks in the womb can make a world of difference for a baby's health.

That's the conclusion of a study published in the journal Pediatrics that found that infants born at 35 or 36 weeks' gestation, rather than the optimal 40 weeks, have a higher risk of complications. Those problems include low blood sugar, jaundice and difficulty regulating body temperature.

"Near-term babies fared worse than full-term babies," Dr. Marvin Wang, a pediatrician from Massachusetts General Hospital for Children and an author of the study, told HealthDay . "Near-term infants are more likely to have typical illnesses that we infrequently see in full-term babies, and parents need to be prepared that there will be more lab work and treatment and more support required than for a full-term baby."

The good news is that Wang said he didn't think there would be long-term consequences from near-term deliveries.

"These are issues that when you detect and treat them, you get over them very quickly," he noted.

Any baby born before 37 weeks is considered premature, according to the American Academy of Family Physicians. The earlier in the pregnancy a baby is born, the higher the risk of health problems. Generally, however, babies born at 35 or 36 weeks do very well, which Wang said presents doctors with unique challenges.

"These are babies in between premature and not-quite-full-term, so you have to wonder when they have symptoms like breathing difficulty if it's because they're sick like a full-term or is it a preemie problem such as immature lungs?" he said.

Wang and his colleagues examined the records of 90 near-term infants who were born at 35 or 36 weeks and compared them with 95 full-term babies who were born after 37 weeks.

The researchers compared a variety of factors, including length of hospital stay, hospital costs, Apgar scores (which indicate vital signs immediately after birth), need for intravenous treatment and the incidence of jaundice, temperature instability, low blood sugar, infections and breathing problems.

Near-term infants had a higher risk of jaundice, low blood sugar, respiratory distress, need for intravenous feeding and problems controlling body temperature. They also were more likely to have multiple health problems than were full-term infants.

Near-term infants also cost significantly more than full-term babies -- about $2,600 more, according to Wang.

This study "gives us numbers for what all of us who treat these babies know to be true: Babies are supposed to go full-term for a reason, and babies born even a few weeks early are more likely to have problems," Dr. Robin Steinhorn, head of neonatology at Children's Memorial Hospital in Chicago, told HealthDay .

Both Steinhorn and Wang said the study's findings should reinforce the need to not schedule delivery before 37 weeks unless there's an urgent need.