Current practices could lead to serious public health problems
While late preterm deliveries have become more common in the industrialized world, the long-term consequences on the health of newborns are still not well understood. Recent evidence indicates that these consequences are far from negligible, according to an editorial by Dr. Michael Kramer of McGill University and the Research Institute of the Montreal Children's Hospital at the MUHC, to be published Dec. 11 in The Journal of Pediatrics.
Late preterm babies, or those born between 34 and 36 completed weeks of gestation, suffer from fewer problems than early preterm babies (those born before 34 weeks of gestation). Late preterm babies face three times the risk of developing cerebral palsy, and a slightly higher risk of developmental delay than full term babies. “Although the absolute risks are low for individual babies, they could become a public health problem because of the growing number of these births in the general population,” Kramer explained.
Two main factors have contributed to this trend: the rise in induced preterm deliveries (due to problems with the mother or the fetus) and infertility treatments. Both in-vitro fertilization (IVF) techniques with transfer of multiple embryos, which is common with IVF treatment, and ovarian stimulation often result in twin or higher-order multiple births (triplets, quadruplets). More than half of all twins and virtually all higher-order multiples are born preterm.
Further study is required to determine when doctors should induce labour and when they should avoid this measure. “Ideally, obstetricians and pediatricians should inform future mothers about the potential health risks associated with late preterm delivery,” said Dr. Kramer. “The risks must be carefully weighed before a decision is made that could have serious consequences on the newborn.”
Dr. Michael Kramer is a researcher in the Health Outcomes Axis of the Research Institute of the MUHC as well as a professor in the Departments of Pediatrics and of Epidemiology and Biostatistics at McGill University’s Faculty of Medicine. He is also Scientific Director of the Institute of Human Development, Child and Youth Health (IHDCYH) of the Canadian Institutes of Health Research (CIHR).
About the Research Institute of the MUHC
The Research Institute of the McGill University Health Centre (RI MUHC) is a world-renowned biomedical and health-care hospital research centre. Located in Montreal, Quebec, the institute is the research arm of the MUHC, the university health centre affiliated with the Faculty of Medicine at McGill University. The institute supports more than 600 researchers, nearly 1,200 graduate and post-doctoral students and operates more than 300 laboratories devoted to a broad spectrum of fundamental and clinical research. The Research Institute operates at the forefront of knowledge, innovation and technology and is inextricably linked to the clinical programs of the MUHC, ensuring that patients benefit directly from the latest research-based knowledge.
The Research Institute of the MUHC is supported in part by the Fonds de la recherche en santé du Québec. For further details visit: www.muhc.ca/research.
About McGill University
McGill, Canada’s leading university, has two campuses, 11 faculties, 10 professional schools, 300 programs of study and more than 33,000 students. Since 2000, more than 800 professors have been recruited to McGill to share their energy, ideas and cutting-edge research. McGill attracts students from more than 160 countries around the world. Almost half of McGill students claim a first language other than English – including 6,000 francophones – with more than 6,200 international students making up almost 20 per cent of the student body.