Early School-Age Outcomes of Late Preterm Infants

Late preterm infants represent a significant portion of preterm deliveries. Until recently, these infants have received little attention because of assumptions that they carry minimal risk for long-term morbidities. The purpose of this study was to compare prekindergarten and kindergarten outcomes among healthy late preterm infants, 34 0/7 to 36 6/7 weeks' gestation at birth, and healthy term infants, 37 0/7 to 41 6/7 weeks' gestation at birth. The study sample consisted of singleton infants who were born in Florida between January 1, 1996, and August 31, 1997, with a gestational age between 34 and 41 weeks (N = 161804) with a length of stay < or =72 hours. Seven early school-age outcomes were analyzed. Outcomes were adjusted for 15 potential confounding maternal and infant variables. Unadjusted and adjusted relative risk with 95% confidence interval was estimated for each outcome by using Poisson regression modeling. Risk for developmental delay or disability was 36% higher among late preterm infants compared with term infants. Risk for suspension in kindergarten was 19% higher for late preterm infants. The remaining 4 outcomes, disability in prekindergarten at 3 and 4 years of age, exceptional student education, and retention in kindergarten, all carried a 10% to 13% increased risk among late preterm infants. The assessment "not ready to start school" was borderline significant. This study suggests that healthy late preterm infants compared with healthy term infants face a greater risk for developmental delay and school-related problems up through the first 5 years of life.