LATE PREMATURE INFANTS – AN UNDERESTIMATED HIGH-RISK GROUP IN NEONATOLOGY

The risks associated with late preterm births have historically been significantly underestimated. Late preterm infants (LPIs) are born with structurally and functionally immature lungs, characterized by insufficient surfactant production, reduced lung volume and surface area, and thickened alveolar walls—factors that collectively impair efficient gas exchange. In addition to pulmonary immaturity, other vital organs and systems, particularly the brain, also remain underdeveloped. Although the majority of LPIs are delivered and discharged home in satisfactory clinical condition, they exhibit markedly higher rates of both perinatal and long-term morbidity and mortality compared to full-term neonates. As a result, this population requires substantially greater medical and social care resources. Preventing late preterm births and ensuring meticulous monitoring of LPIs during the postnatal adaptation period are therefore essential. Particular attention should be paid to the prevention, timely diagnosis, and management of hypothermia, respiratory and metabolic disturbances, infectious complications, feeding difficulties, and other associated conditions. Currently, there is a lack of robust evidence to support a standardized clinical protocol for the management of pulmonary disorders in LPIs. Approximately half of these infants diagnosed with respiratory distress syndrome (RDS) may require surfactant therapy. The criteria presented in this publication are intended to assist clinicians in making evidence-informed decisions regarding surfactant administration in this specific patient group. Primary care providers should be well-acquainted with the distinct clinical characteristics of late preterm infants and must ensure ongoing monitoring of their nutritional status, general health, and developmental progress.