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Late-Preterm and Early-Term Newborns: Risk Factors, Outcomes and New Challenges

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A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: closed (10 January 2026) | Viewed by 12703

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Special Issue Editor

Dr. Katarzyna Wroblewska-Seniuk

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Guest Editor

II Department of Neonatology, Poznan University of Medical Sciences, ul. Polna 33, 60-535 Poznan, Poland
Interests: newborns' infectious diseases; congenital and acqyired CMV infection; postnatal growth faltering; newborns of diabetic mothers; late-preterm and early-term infants
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Special Issue Information

Dear Colleagues,

Late-preterm (born between 34^0/7 and 36^6/7 weeks of gestation) and early-term (37^0/7-38^6/7) infants are the fastest-growing subgroups of neonates. In Western countries, late-preterm and early-term birth rates range from 3% to 6% and from 15% to 30%, respectively, and over the past decade, they have increased by around 10%.

Late-preterm infants generally appear to be relatively mature and healthy; however, emerging evidence identifies them as being at a significant risk of several neonatal morbidities. Recent research shows that early-term newborns, who usually look like full-term infants, are more likely to experience adverse neonatal outcomes than those born after 39 weeks.

As the Guest Editor of this Special Issue, ‘Late-Preterm and Early-Term Newborns: Risk Factors, Outcomes and New Challenges’, I cordially invite you to submit reviews, research articles, or case reports, which will undoubtedly broaden our knowledge on health challenges posed by late-preterm and early-term infants.

Dr. Katarzyna Wroblewska-Seniuk
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

late-preterm newborns
early-term newborns
neonatal morbidity
prematurity risk factors
respiratory disease
neurodevelopmental outcomes
neonatal infections

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Published Papers (5 papers)

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Research

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12 pages, 591 KB

Open AccessArticle

Neurodevelopment at Two Years in Preterm Infants: Corrected Versus Chronological Age

by Barbara Caravale, Valentina Focaroli, Elvira Caramuscio, Cristina Zitarelli, Francesco Pisani, Corinna Gasparini, Paola Ottaviano, Antonella Castronovo, Marzia Paoletti, Daniela Regoli, Lucia Dito, Gianluca Terrin and Rosa Ferri

Children 2026, 13(2), 219; https://doi.org/10.3390/children13020219 - 4 Feb 2026

Viewed by 954

Abstract

Background: Preterm birth is a significant risk factor for neurodevelopmental delays, but the appropriate use and timing of age correction for developmental assessment remain debated. Objective: This study investigated psychomotor development in preterm children at two years of age, with the aim of clarifying whether age correction remains necessary at this stage, particularly across different gestational age groups. Methods: A total of 161 preterm infants were assessed at a mean chronological age of 25.4 months (mean corrected age: 23.3 months) and compared with two control groups of typically developing children matched for gender and either corrected age (Control–Corr, N = 88) or chronological age (Control–Chron, N = 87). The preterm group was further stratified by gestational age: extremely preterm (<28 weeks), very preterm (28–31 weeks), and moderate-to-late preterm (32–36 weeks). Cognitive, Language (Receptive, Expressive), and Motor (fine, gross) scales of Bayley-III were analysed using t-tests and MANOVAs. Results: Using corrected age, preterm children showed a selective profile, with deficits in Receptive Language, borderline mean score in Gross Motor, and preserved performance in Cognitive, Expressive Communication, and Fine Motor. When compared with controls of the same age, significant differences emerged in the Cognitive, Language, and Gross Motor, but not Fine Motor, domains. In contrast, scoring by chronological age produced a generalised delay, with preterm children performing significantly worse than chronological-age controls across all domains. Subgroup analyses further showed that extremely preterm children already displayed marked Language vulnerabilities at corrected age, which became more severe with chronological scoring and extended to other domains. Very preterm children also fell into the deficit range in Cognitive, Language, and Gross Motor scales/subscales when chronological age was applied, whereas moderate-to-late preterm children performed comparatively better. Conclusions: Developmental assessment using corrected age remains essential at least until 24 months, especially for extremely and very preterm children, to avoid substantial overestimation of developmental difficulties. Chronological scoring, while helpful to highlight persistent vulnerabilities, may inflate delay classification if used too early. Tailoring correction strategies by gestational age and developmental domain could provide a more accurate and clinically meaningful representation of preterm children’s developmental trajectories. Full article

(This article belongs to the Special Issue Late-Preterm and Early-Term Newborns: Risk Factors, Outcomes and New Challenges)

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Review

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33 pages, 5023 KB

Open AccessReview

Postnatal Steroids in Preterm Infants: A Narrative Review Series—Part 3: Impacts on Growth, Neurodevelopment & Nutrition

by Phoenix Plessas-Azurduy, Jarred Garfinkle, Marc Beltempo, Caroline Porraccio, Anie Lapointe, Laila Wazneh, Punnanee Wutthigate, Sarah Spénard, Anne Marie Sbrocchi, Marie-Brossard Racine, Wadi Mawad, Tiscar Cavallé-Garrido, Wissam Shalish, Guilherme Sant’Anna and Gabriel Altit

Children 2026, 13(4), 475; https://doi.org/10.3390/children13040475 - 29 Mar 2026

Viewed by 1256

Abstract

Background: Postnatal corticosteroids (CS) improve respiratory outcomes in preterm infants, but effects on growth and neurodevelopment remain incompletely understood. Methods: This third instalment of a narrative review series builds on physiologic principles to examine systemic CS consequences. Main Findings: We explore the interplay between growth restriction, hypoxia, and neurodevelopmental vulnerability, discussing brain imaging, metabolic disruptions, and HPA axis suppression. Conclusion: This review advocates for a holistic, physiology-informed approach to optimize outcomes by integrating nutritional vulnerability with cardiorespiratory status. Full article

(This article belongs to the Special Issue Late-Preterm and Early-Term Newborns: Risk Factors, Outcomes and New Challenges)

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26 pages, 3225 KB

Open AccessReview

Postnatal Steroids in Preterm Infants: A Narrative Review Series—Part 2: Cardiovascular Impacts

by Phoenix Plessas-Azurduy, Anie Lapointe, Punnanee Wutthigate, Sarah Spénard, Andréanne Villeneuve, Audrey Hébert, Eilon Shany, Justin Richardson, Neta Geva, Wadi Mawad, Tiscar Cavallé-Garrido, Marc Beltempo, Wissam Shalish, Guilherme Sant’Anna and Gabriel Altit

Children 2026, 13(3), 395; https://doi.org/10.3390/children13030395 - 12 Mar 2026

Viewed by 1095

Abstract

Postnatal corticosteroids are frequently administered to extremely preterm infants to support respiratory management, yet their effects on the immature cardiovascular system are complex and underexplored. As the second installment in a series on physiology-informed steroid use, this narrative review focuses on the cardiovascular consequences of systemic corticosteroid therapy in preterm neonates. We examine how corticosteroids influence key aspects of cardiovascular physiology, including ductal closure, systemic and pulmonary vascular resistance, myocardial remodeling, and autonomic regulation. Attention is given to the hemodynamic transition of early postnatal life and how steroid exposure may interact with patency of the ductus arteriosus and vascular development. The potential for corticosteroids to contribute to reactive myocardial hypertrophy, systemic hypertension, and pulmonary hypertension is also reviewed in the context of both short- and long-term outcomes. Emerging diagnostic and monitoring tools are discussed for their potential to guide individualized therapy. These include targeted neonatal echocardiography (TnECHO) to assess cardiac function and structure, electrocardiography (ECG) for rhythm and conduction abnormalities, heart rate variability analysis for autonomic function, and circulating biomarkers to evaluate myocardial stress and inflammation. Together, these tools may inform tailored steroid timing and dosing, especially in the research context, while monitoring for signs of cardiovascular side effects in real time. By synthesizing mechanistic insights with evolving clinical evidence, this review highlights the need for a more nuanced understanding of how corticosteroids affect the developing cardiovascular system. It underscores the importance of integrating cardiovascular monitoring into routine care to optimize therapeutic benefit while minimizing unintended harm. Alongside companion reviews addressing respiratory and growth impacts, this installment contributes to a broader framework for individualized, physiology-driven steroid use in extremely preterm infants. Full article

(This article belongs to the Special Issue Late-Preterm and Early-Term Newborns: Risk Factors, Outcomes and New Challenges)

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29 pages, 2344 KB

Open AccessReview

Postnatal Steroids in Preterm Infants: A Narrative Review Series—Part 1: Inflammatory Modulation and Respiratory Impacts

by Phoenix Plessas-Azurduy, Anie Lapointe, Punnanee Wutthigate, Sarah Spénard, Marc Beltempo, Wissam Shalish, Guilherme Sant’Anna and Gabriel Altit

Children 2026, 13(3), 384; https://doi.org/10.3390/children13030384 - 9 Mar 2026

Viewed by 1625

Abstract

Extremely preterm infants often require prolonged respiratory support due to lung immaturity and inflammation, placing them at high risk of lung injury and development of bronchopulmonary dysplasia (BPD). In many of these infants, systemic postnatal corticosteroids are used to reduce lung inflammation, facilitate mechanical ventilation (MV) weaning and extubation, and improve short-term pulmonary outcomes. However, despite decades of clinical use, substantial variation persists in timing, choice of agent and dosing. These inconsistencies reflect a lack of strong evidence and a limited understanding of the systemic and organ-specific effects of therapy for a highly heterogenous population usually exposed to this medication. This narrative review addresses these gaps by integrating current knowledge of the inflammatory and respiratory effects of postnatal corticosteroids in extremely preterm infants. We explore how corticosteroids modulate pulmonary inflammation, their effects on lung development, and how they affect key clinical outcomes such as extubation success and BPD severity. We also examine evolving approaches to corticosteroid administration and dosing, highlighting the importance of individualized strategies informed by developmental and disease-specific considerations. Comparative data from randomized controlled trials are reviewed, including the efficacy and side-effect profiles of commonly used regimens. Current evidence supports judicious use of late low-dose dexamethasone, while early prophylaxis with inhaled or intratracheal steroids remains experimental and is not routinely advised. In line with a physiology-driven approach, we also discuss emerging domain-specific monitoring tools that may enhance patient selection and optimize timing of intervention. By synthesizing mechanistic insights with clinical evidence, this review supports a more nuanced, individualized approach to postnatal corticosteroid therapy in extremely preterm infants, balancing therapeutic benefits with potential systemic trade-offs. Full article

(This article belongs to the Special Issue Late-Preterm and Early-Term Newborns: Risk Factors, Outcomes and New Challenges)

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23 pages, 1023 KB

Open AccessReview

Short- and Long-Term Consequences of Late-Preterm and Early-Term Birth

by Muhammad Arham and Katarzyna Wróblewska-Seniuk

Children 2025, 12(7), 907; https://doi.org/10.3390/children12070907 - 9 Jul 2025

Cited by 2 | Viewed by 6991

Abstract

Late-preterm (34^0/7–36^6/7 weeks) and early-term (37^0/7–38^6/7 weeks) newborns were, up until recently, erroneously categorized as low-risk and were conflated with full-term (39^0/7–40^6/7 weeks) deliveries. However, emerging evidence refuted this notion and demonstrated that late-preterm and, to a lesser extent, early-term newborns have a significantly higher risk of experiencing various neonatal morbidities, including respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, jaundice, hypoglycemia, and breastfeeding difficulties, compared to their full-term counterparts—reflecting their relative physiologic and developmental immaturity. Recent evidence also unravels the lingering adverse effects of late-preterm and early-term delivery up until mid-adulthood, with the increased susceptibility of these newborns to neurodevelopmental delays, behavioral and neuropsychiatric problems, and adult chronic diseases. Moreover, apart from increased neonatal and infant mortality rates, these newborns continue to encounter a heightened risk of mortality even up to mid-adulthood. As the full spectrum of the complications these newborns face is gradually being unveiled, this review presents and discusses the current knowledge base, identifies gaps in the literature, and highlights future research implications. Full article

(This article belongs to the Special Issue Late-Preterm and Early-Term Newborns: Risk Factors, Outcomes and New Challenges)

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