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Short-term clinical outcomes of late preterm infants

후기 조산아들의 단기 임상적 결과

  • Na, Ji Youn (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Park, Narimi (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Kim, Eun Sun (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Lee, Hyun Ju (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Shim, Gyu Hong (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Lee, Jin-A (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Choi, Chang Won (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Kim, Ee-Kyung (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Kim, Han-Suk (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Kim, Beyong Il (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Choi, Jung-Hwan (Department of Pediatrics, College of Medicine, Seoul National University)
  • 나지윤 (서울대학교 의과대학 소아과학교실) ;
  • 박나리미 (서울대학교 의과대학 소아과학교실) ;
  • 김은선 (서울대학교 의과대학 소아과학교실) ;
  • 이현주 (서울대학교 의과대학 소아과학교실) ;
  • 심규홍 (서울대학교 의과대학 소아과학교실) ;
  • 이진아 (서울대학교 의과대학 소아과학교실) ;
  • 최창원 (서울대학교 의과대학 소아과학교실) ;
  • 김이경 (서울대학교 의과대학 소아과학교실) ;
  • 김한석 (서울대학교 의과대학 소아과학교실) ;
  • 김병일 (서울대학교 의과대학 소아과학교실) ;
  • 최중환 (서울대학교 의과대학 소아과학교실)
  • Received : 2008.08.07
  • Accepted : 2008.10.26
  • Published : 2009.03.15

Abstract

Purpose : To identify the short-term clinical outcomes of late preterm infants and to test the hypothesis that late preterm infants have more clinical problems during the early postnatal period than term infants. Methods : One hundred late preterm infants [gestational age (GA) $34^{+0}$-$36^{+6}$ weeks] and the same number of term infants (GA $37^{+0}$-$41^{+6}$ weeks) were randomly selected from 289 late preterm infants and 825 term infants born in the Seoul National University Bundang Hospital between January 2007 and December 2007, and their electronic medical records were reviewed and analyzed. Results : Compared to term infants, late preterm infants had significantly more medical problems such as temperature instability (odds ratio [OR] 8.7), hypoglycemia (OR 17.5), intravenous fluid infusion (OR 10.2), evaluation for sepsis (OR 9.4), respiratory problems (OR 7.5), apnea and bradycardia (OR 8.6), phototherapy for jaundice (OR 3.6), and feeding intolerance (OR 10.0). Hospital stay was also significantly longer in late preterm infants. Conclusion : Late preterm infants had significantly more medical problems and increased length of hospital stay compared to term infants. More attention should be given to caring for these late preterm infants in newborn nursery during the early postnatal period.

목 적 : 후기 조산아들의 단기 임상적 결과들을 알아보고 후기 조산아들이 만삭아들에 비해 출생 초기에 임상적 문제들이 더 많이 발생할 것이라는 가설을 검정해보고자 하였다. 방 법 : 2007년 1월 1일부터 2007년 12월 31일까지 분당서울대학교병원에서 출생하여 신생아중환자실 또는 신생아실에 입원한 신생아들 중에서 재태 주령 $34^{+0}$-$36^{+6}$주에 해당하는 후기 조산아 289명 중 100명과 재태주령 $37^{+0}$-$41^{+6}$주에 해당하는 만삭아 825명 중 100명을 무작위로 추출하여 그들의 의무기록을 고찰하고 분석하였다. 결 과 : 후기 조산아들은 만삭아들에 비해 체온불안정[Odds ratio (OR) 8.7], 저혈당증(OR 17.5), 정맥 카테터 삽입(OR 10.2), 조기 신생아 패혈증에 대한 검사 시행(OR 9.4), 호흡 곤란(OR 5.3), 호흡곤란에 대한 치료로 비강내 지속적 양압환기 사용(OR 7.5), 무호흡증 또는 서맥(OR 8.6), 황달로 인한 광선치료(OR 3.6), 수유 지연(OR 10.0)과 같은 임상적 문제들이 유의하게 많이 발생하였고 이들의 입원 일수도 만삭아들에 비해 유의하게 길었다. 결 론 : 후기 조산아들은 만삭아들에 비하여 출생 초기에 유의하게 많은 임상적 문제들을 갖고 있기 때문에 신생아실에서의 이들의 관리에 좀 더 많은 주의가 필요할 것으로 생각된다.

Keywords

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