Kristie McNealy, MD

A new study demonstrates the vulnerability of babies born between 34 and 36 weeks gestation (full term is reached at 37 weeks). Babies born during this critical period of development have reduced fat stores, immature lungs and livers, and a brain volume that is just 60% of a baby born at term. As many as three-quarters of babies born at 34 weeks end up in the neonatal intensive care unit to receive specialized care. In addition, babies born between 34 and 36 weeks are 6 times more likely to die in the first week, and 3 times more likely to die in the first year than their term peers.

These findings are alarming, because late preterm births are the most rapidly growing segment of preterm births in the US, accounting for about 350,000 births each year, and these babies often fall through the cracks. However, if you deliver a baby during this time frame, don’t panic. The majority of babies born between weeks 34 and 36 are healthy and do fine. The number that suffer from complications like breathing problems, jaundice, feeding difficulties and unstable body temperatures is between 17 and 34%.

One of the reasons late preterm births are on the rise may be a combination of a lack of awareness about the issues associated with delivery during this gray zone, and a desire on the part of physicians and mothers to deliver babies at the slightest sign of increased blood pressure or other complications to prevent further problems down the line. Clearly, women and physicians both need to be educated on the dangers of unnecessary delivery during this critical period of development. Learning about this study certainly gives me a new appreciation for the perinatologist who intervened during my last pregnancy when my OB stopped my preterm labor medications at 34 weeks. Her actions are probably the reason we were blessed with a healthy, 39 week baby boy.

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