Common Complications of the Late Preterm Infant-Common Complications of the Late Preterm Infant

Video Transcription

Video Summary

This comprehensive presentation, a collaboration between the American Academy of Emergency Nurse Practitioners and the National Association of Neonatal Nurses, focuses on common complications in late preterm infants (born 34 to 36 weeks, 6 days gestation). These infants appear healthy but face significantly higher risks for rehospitalization and complications such as hyperbilirubinemia, infection/sepsis, hypoglycemia, hypothermia, feeding difficulties, and respiratory distress.<br /><br />Key points include the use of assessment tools like PD Tools or Billy Tools to evaluate bilirubin levels and guide management of hyperbilirubinemia, with attention to risk factors like ABO incompatibility and feeding patterns. Sepsis evaluation emphasizes early recognition of non-specific signs, obtaining blood, urine, and CSF cultures rapidly, and prompt initiation of empiric antibiotics within 60 minutes, tailored to early or late onset infections. Hypoglycemia in late preterm infants arises from immature glucose regulation and limited glycogen stores; treatment involves D10 boluses and continuous glucose monitoring.<br /><br />Hypothermia risk stems from insufficient brown fat and immature thermoregulation; management involves gradual rewarming and careful monitoring. Feeding difficulties are often due to neurological immaturity, decreased oral motor coordination, and can signal serious conditions like malrotation with midgut volvulus—a surgical emergency often presenting with bilious vomiting requiring urgent referral. Respiratory distress may result from multiple etiologies including aspiration, infection, cardiac defects, or persistent pulmonary hypertension; supportive care ranges from oxygen and suctioning to advanced airway management.<br /><br />Overall, emergency and neonatal providers should perform careful assessments using tools like the pediatric assessment triangle, maintain broad differential diagnoses (“MISFITS” mnemonic), and coordinate care based on resources and clinical presentation. Family-centered approaches including maternal support and postpartum depression screening are encouraged to optimize outcomes. This module enhances knowledge for emergency and neonatal practitioners caring for late preterm infants during early post-discharge presentations.

Keywords

late preterm infants

hyperbilirubinemia

infection

sepsis

hypoglycemia

hypothermia

feeding difficulties

respiratory distress

assessment tools

pediatric assessment triangle

MISFITS mnemonic

family-centered care