Newborn clinical outcomes of the awhonn late preterm infant research-based practice project

Objective: To describe the neonatal health risks (hypothermia, hypoglycemia, hyperbilirubinemia, respiratory distress, the need for a septic workup, and feeding difficulties) experienced by late preterm infants (LPIs) from a large multisite study and determine how these risks were affected by gestational age at birth. Design: Descriptive analysis of prospective data obtained as part of the AWHONN Late Preterm Infant Research-Based Practice Project. Setting: Fourteen hospitals located through the United States and Canada. Participants: Late preterm infants (802) born at gestational ages between 34 0/7 and 36 6/7 weeks. Methods: Nurses at each site obtained consent from the mother of the infant. The data about the infant were gathered from the infant's medical record. Results: Thirty-six percent of LPIs were initially cared for in a special care nursery; approximately one half of these infants were eventually transferred to a well-baby nursery. Of the 64% of LPIs initially cared for in a routine nursery, 10% were transferred to a special care unit or neonatal intensive care unit (NICU). More than one half of LPIs experienced hypothermia, hypoglycemia, feeding difficulties, hyperbilirubinemia, and respiratory distress and/or needed a septic workup. The risk for these problems was higher in infants of younger gestational ages. Thirty-two percent of the infants were bathed during the first 2 hours of life, and by 4 hours, more than two thirds had had their first bath. Fifty-two percent received kangaroo care during the first 48 hours of life. Conclusion: These findings support those of smaller studies indicating that LPIs are at high risk for developing health problems during their neonatal hospitalization. Nurses may be able to ameliorate some of these health problems through early identification of problems and simple, inexpensive interventions such as avoiding early bathing and promoting kangaroo care.