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Late preterm infants are infants born at a gestational age between 34 + 0 ⁄ 7 weeks and 36 + 6 ⁄ 7 weeks. [1] They have higher morbidity and mortality rates than term infants (gestational age ≥37 weeks) due to their relative physiologic and metabolic immaturity, even though they are often the size and weight of some term infants.
The rates of maternal and infant mortality due to complications of pregnancy have decreased by over 23% since 1990, from 377,000 deaths to 293,000 deaths. Most deaths can be attributed to infection, maternal bleeding, and obstructed labor, and their incidence of mortality vary widely internationally. [ 10 ]
Adults born preterm have higher all-cause mortality rates as compared to full-term adults. Premature birth is associated with a 1.2x to 1.6x increase in all-cause mortality rates during early to mid-adulthood. Those born extremely prematurely (22–27 weeks) have an even higher mortality rate of 1.9x to 4.0x. [3]
[4] [5] In those with pre-eclampsia, delivery of the baby and placenta is an effective treatment [4] but full recovery can take days or weeks. [13] The point at which delivery becomes recommended depends on how severe the pre-eclampsia and how far along in pregnancy a woman is. [4]
Eclampsia, like pre-eclampsia, tends to occur more commonly in first pregnancies than subsequent pregnancies. [38] [39] [40] Women who have long term high blood pressure before becoming pregnant have a greater risk of pre-eclampsia. [38] [39] Patients who have gestational hypertension and pre-eclampsia have an increased risk of eclampsia. [41]
Preeclampsia superimposed on chronic hypertension occurs when a pregnant woman with chronic hypertension develops signs of pre-eclampsia, typically defined as new onset of proteinuria ≥30 mg/dL (1+ in the dipstick) in at least 2 random urine specimens that were collected ≥4 h apart (but within a 7-day interval) or 0.3 g in a 24-h period. [19]
This scoring allows for the estimation of age in the range of 26 weeks to 44 weeks. The New Ballard Score is an extension of the above to include extremely pre-term babies , i.e., up to 20 weeks. The scoring relies on the intra-uterine changes that the fetus undergoes during its maturation.
The total (crude) birth rate (which includes all births)—typically indicated as births per 1,000 population—is distinguished from a set of age-specific rates (the number of births per 1,000 persons, or more usually 1,000 females, in each age group). [5]