| Previous studies in preterm infant focused on infant of low birth weight below 1,500 grams, while for larger preterm children with advanced gestational age, or nearly full-term infant hildren (late preterm infant),study was relatively small. But the last full-term children (34～36 +6 weeks pregnant) appear in a high proportion of premature infant, and little is known about its causes. Nearly full-term infant always have normal Apgar score and birth weight at or near the normal range. Clinicians pay much less attention to near-term infant than early preterm infant. Because its physiological and metabolic functions have not yet fully mature, its complications (such as respiratory distress syndrome, sepsis, hypoglycemia, jaundice, asphyxia, apnea, feeding problems, temperature instability, etc.) is more likely to occur than the full-term children, leading to its higher mortality and morbidity during hospitalization. Despite the growing prevalence of this group, its study of mortality and morbidity is still stuck in the level of study on risk factors at birth. This study is to investigate the clinical data of nearly full-term infant, and to explore the disease's composition of infant after the birth and its prognosis, etc.Object and methods1 Object and groupPatients were divided into three groups according to gestational age, namely A:Early preterm infant group (28～33 +6 weeks gestational age) with 380 cases in total, B group:nearly full-term infant group (gestational age of 34～36 +6 weeks) with 318 cases in total, C Group:full-term infant group (37～41+6 weeks gestational age) with 223 cases in total; and 318 cases of near full-term children were divided into three groups:a group of natural labor, unexplained vaginal or PROM and premature delivery persons, a total of 49 cases; b group referring to the infant with premature birth by selective caesarean section because of medical reasons such as the existence of obstetric complications, a total of 171 cases; c group referring to the infant with premature birth by selective caesarean section because of social factors or preterm premature rupture of membranes, a total of 98 cases.2 Outcome measuresClinical data such as birth weight, Apgar score, the major diseases after birth and their prognosis in these infant were analysed statistically. Clinical data were evaluated, including hospital days, gestational age (GA), birth weight (BW), delivery mode, and clinical diseases constitution, such as respiratory distress syndrome pose (RDS), low blood sugar, neonatal infections, asphyxia, body temperature instability, intravenous nutrition, neonatal hyperbilirubinemia, pneumonia and sepsis.3 Clinical data collectiona Obstetric data collection:Including general information of mothers, the incidence of pregnancy complications such as the time of premature rupture of membranes, and with or without infection, as well as the presence of placental abruption, pregnancy-induced hypertension syndrome and so on. And we had a simple understanding of prenatal maternal drug use situation (glucocorticoid drugs, etc.).b Situation of newborn at birth:including birth weight, delivery methods, Apgar score in 1 minute, Apgar score in 5 minutes, the situation of amniotic fluid, umbilical cord and placenta, recovery with or without asphyxia history and so on.c Data collection of newborn:Transferring to neonatal intensive care unit, and monitoring vital signs of the neonatal. Observe and record the situation of the disease in newborns mainly, as well as body temperature, blood sugar, feeding problems, and other basic vital signs.4 All data were analysed using SPSS16.0 statistical software, with measurement data using the mean±standard deviation (x±s). The data accorded to the normal distribution, and multiple analysis of variance was used during groups. Count data was analysed using Chi-square test, and withα=0.05 as the standard.The corrected chi-square test was used between groups, withα=0.017 as the standard. Results1 According to the analysis of the diseases' composition among the three groups (early preterm infant, nearly full-term infant, full-term infant) after the birth, we could see that the incidence of neonatal respiratory distress syndrome, hypoglycemia, newborn children asphyxia, neonatal infections, neonatal hyperbilirubinemia, hypothermia and feeding problems due to application of parenteral nutrition was statistically significant different (P<0.05). The group of early preterm infant was higher than the other two groups; while group of nearly full-term infant was higher than full-term infant obviously. In the groups with neonatal respiratory distress syndrome, comparison between the groups were significantly different (P<0.017). Comparison of data on low blood sugar, neonatal asphyxia, hypothermia, and the application of parenteral nutrition between C and A group was significantly different, as well as the comparison between C and B group (P<0.017). Full-term infant was significantly different comparing to the early preterm infant, as well as comparing to the nearly full-term infant.2 Near term gestational age and birth weight analysis of the infant in each group indicated that the birth weight in a group, b group and c group were (2435±482) g, (1856±503) g, (2038±611) g separately. Most of a group were appropriate for gestational age or gestational age, while the majority of the preterm birth group were small for gestational age.3 The composition analysis of the disease in nearly full-term children after the birth indicated that the incidence of neonatal asphyxia, pneumonia and sepsis among the groups had no significant difference (P>0.05), and there was no statistical significance; while the incidence of low blood sugar, neonatal respiratory distress syndrome, neonatal infections and neonatal hyperbilirubinemia in b group and c group was significantly higher than that of a group, and the difference was statistically significant (P<0.05).In the infant with neonatal respiratory distress syndrome, comparisons between the groups were significant different (P<0.017), while the incidence of low blood sugar, neonatal infections, neonatal hyperbilirubinemia in a group, b group and c group had statistically significant difference (P<0.017) pairwise.4 In nearly full-term infant, the total number of hospital days and the Apgar score were different among the groups. Data analysis indicated that the total number of hospital days of a group was shorter than that of b, c group. The birth Apgar score of a group was also relatively higher (9.34±0.58), and b group (7.03±1.01), while c group (8.02±0.62) was much closer to that in full-term infant, that was, within the normal range. And the difference was statistical pairwise.Conclusions1 Compared to term infant, nearly full-term infant had the relatively higher incidence in the neonatal respiratory distress syndrome, hypoglycemia, asphyxia, infection, hyperbilirubinemia, low body temperature, the application of parenteral nutrition, and soon.2 Nearly full-term infant suffering from diseases of respiratory distress syndrome, neonatal morbidity was 26.10%.The choice of delivery methods, especially selective caesarean section is the main risk factor of suffering from RDS in nearly full-term infant. (The proportion of more than 90.00%)...
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