Place of Birth and Variations in Management of Late Preterm (“Near-Term”) Infants

BackgroundThe purpose of this study is to characterize variations in management late preterm infants because such variations in such a large group of neonates would have economic and health implications.MethodsComparison of the use of illustrative management approaches and gestational age at discharge among infants born at 33 to 34 6/7 weeks and discharged alive from 10 Massachusetts and California NICUs.ResultsGenerally similar in birth weight and admission severity, significant differences were seen in illustrative interventions, such as the use of mechanical ventilation (range in use across hospitals from 9% to 43%) and nutritional practices (use of hyperalimentation ranged from 5% to 66%). Variations in average daily weight gain were seen with some infants averaging net losses. Postmenstrual age at discharge varied by a week between the hospital with the earliest discharge and that with the latest.ConclusionsCare for these infants would be improved by further examination of their needs and the establishment of practice guidelines to reduce unneeded variation.