Pretest

Please follow the link below to take the short pretest for the material on "Late Preterm Birth".  At the end of the quiz, you will get a score as a percentage, which is really just for your own personal awareness, but it will also show how you compare to others who have already taken it.  After you have had time to watch the lecture "Late Preterm Birth - What YOU Need to Know" and read through other info here on the site, PLEASE DON'T FORGET TO TAKE THE POST-TEST to see how much you've learned.  Answers to the post-test are available below the post-test, so you can learn anything you might have still missed.  Your (anonymous) scores from both the pre- and post-test will be used to help me evaluate the website (and whether or not visitors like you actually increased their knowledge), so please do your best. 

 Click here to take the short Pretest Quiz

HIGH YIELD: click on the link above to take the short pretest.  After you have had time to watch the lecture: "Late Preterm Birth - What YOU Need to Know", take the post-test to see if you learned anything.  Taking these short little quizzes helps me evaluate the site and the online format as a learning tool, so THANK YOU in advance.

SPECIAL NOTE: If you are not comfortable visiting a commercial site to take the pre-test by clicking on the above link [the hosting site Quibblo.com contains third party advertisements in the side column] then you may take the Pre-test by accessing the word document below.  The word document will not calculate your personal score as the Quibblo site will, but you may judge your personal knowledge by writing down your answers and then accessing the "Answers to the Post-test" document at the very bottom of this page and use that to go over your answers.  There is no inherent risk in visiting the Quibblo site and taking the pre-test or post-test quizes, but as always, use your discretion and do not click on any advertisements or links if you do not know who they come from.

Also, feel free to use the Pre-test in its word document form as a teaching aid in other settings, with your colleagues or small group with residents, or any other use you find appropriate.


Pre-test as a Word Document
File Size: 41 kb
File Type: doc
Download File



Late Preterm Birth - What YOU Need to Know

A great deal of information about late preterm birth and late preterm infants has been published in recent years.  If the topic is somewhat new to you, the amount of information can be a little over-whelming.  As a physician or health care provider, what is it that you really need to know in order to understand the issues and be able to make a difference?  Since one of my main objectives for this project is to educate my colleagues about late preterm birth, I have put together a lecture geared towards physicians and physicians-in-training covering the basics of what they should know. 

If you prefer to have the lecture "given" to you, click on the lecture video file, which includes audio discussing the main points of each slide, much like you might experience in a lecture hall.  The video allows you to pause the lecture at any time (to answer pages, etc.) and resume play whenever you are ready.  Total running time is about 30 minutes.  If you prefer to read the slides and go at your own pace, select the PowerPoint presentation file and view as a slide show.  Even if you initially view the lecture video, you can access the PowerPoint file if you want to review one of the slides again later.  

The lecture is a summary of sorts touching on much of the information out there related to late preterm birth, but certainly doesn't cover everything.  On the rest of this page I have posted some of the statements, data, and publications that are available, or at least links to the information, with a short summary before each to help you sift through it all.  As I said on the home page, this website is just meant to be a jumping off point, but hopefully I can get you started in the right direction.  At the very bottom of this page you'll find the post-test and answers.  Don't forget to come back and take the post-test to see how much you've learned.


HIGH YIELD: There is a lot of information about late preterm birth available, but if you don't have time to go through all of it now, I have put together a lecture geared towards physicians and physicians-in-training covering the basics of what you should know.  See the video lecture below if you want to have the information "lectured" to you (about 30 minutes in length), or see the PowerPoint presentation if you want to go through the slides at your own pace.  Don't forget to take the post-test at the end of this page.


Lecture Video here - click Play button to begin.

Power Point Presentation below, click Download File to open on your computer.

Late Preterm Birth - What YOU Need to Know
File Size: 4449 kb
File Type: ppt
Download File


Fun With Numbers

If you like statistics, check out these sources to get an idea of the size of the issues.  Follow the link below to the Peristats webpage, which lets users create maps, graphs, charts, tables or fact sheets with statistics about maternal & infant health data.  Focus on the US as a whole, or select a state for more detailed information.  Arrange information by race, age, or insurance status of Mom, birth weight, delivery method, and many more options!

Peristats - User-friendly Statistics Webpage for Maternal & Infant Health


For a good overview and some basic statistics, see the article below entitled "Late Preterm Birth - Every Week Matters".  To see how the DC metropolitan area stacks up, see the "Report Cards" for DC, Maryland, and Virginia. 
Here's a hint: NO state/district in the area is making a passing grade!


Late Preterm Birth - Every Week Matters
File Size: 176 kb
File Type: pdf
Download File

DC 2008 Report Card for Premature Birth
File Size: 70 kb
File Type: pdf
Download File

MD 2008 Report Card for Premature Birth
File Size: 64 kb
File Type: pdf
Download File

VA 2008 Report Card for Premature Birth
File Size: 64 kb
File Type: pdf
Download File


Recommendations, Statements, and Official Reports

Several national organizations have made some important statements or published official reports about the current status of the Late Preterm Birth issue.  The Surgeon General held a conference last year covering the Prevention of Preterm Birth, what we know, what we don't know but should, and some recommendations for the future.  See the report below, or click the link to the Surgeon General's webpage for more information about the conference.  The National Center for Health Statistics (NCHS) published a report in October 2008 entitled "Recent Trends In Infant Mortality", which has some interesting information on preterm birth and how it affects the infant mortality rate in the United States (which is far worse than other industrialized nations!)  Follow the link for more information on the CDC website.  The Institute of Medicine (IOM) published a full report in 2006 entitled "Preterm Birth: Causes, Consequences, and Prevention".  See the brief of the report below (PDF), or click on the link to go to the IOM website to get the full report (for purchase).

 The American College of Obstetricians and Gynecologists (ACOG) published a "committee opinion" on Late Preterm Infants in April 2008, stating "Preterm delivery should occur only when an accepted maternal or fetal indication for delivery exists.  Collaborative counseling by both obstetric and neonatal clinicians about the outcomes of late-preterm births is warranted unless precluded by emergent conditions."  See the full committee opinion below (PDF), or visit the ACOG website for more information.



surgeon_generals_conference_on_the_prevention_of_preterm_birth_-_june_2008.pdf
File Size: 91 kb
File Type: pdf
Download File


Link to Report from Surgeon General's Conference on the Prevention of Preterm Birth - June 2008


NCHS report: Recent Trends in Infant Mortality
File Size: 1055 kb
File Type: pdf
Download File


Link to National Center for Health Statistics report: Recent Trends in Infant Mortality


IOM brief on 2006 report on Preterm Birth
File Size: 307 kb
File Type: pdf
Download File


Link to Institute of Medicine - Full Report on Preterm Birth: Causes, Consequences, and Prevention


ACOG statement on Late Preterm Birth
File Size: 329 kb
File Type: pdf
Download File


American College of Obstetricians and Gynecologists website


For the pediatricians visiting the site, check out the Pediatric Care Online textbook on the AAP website, Chapter 92: Care of the Late Preterm Infant.  This chapter goes through, you guessed it, everything about Late Preterm Infants and tools for practice.

The American Academy of Pediatrics has also published a policy statement on Hospital Discharge of the High Risk Neonate, which includes a section on Late Preterm Infants. 

Also check out their publication of "Late Preterm Infants: A Population at Risk", which includes a lengthier section on Recommended Minimum Criteria for Discharge of Late Preterm Infants.


Recent Journal Articles

Many articles have been published in the literature in recent years various topics related to Late Preterm Birth.  Here are a few of the interesting ones I found to get you started.  Not all of the links will take you directly to the article, as some require a membership or subscription to view the full article online.  As much as I would love to upload the PDFs directly here for you, I'm sure it is against some copyright laws.  I've tried to at least link you to where the article is located, which provides the full citation and abstract for free in most cases, and if you have an online subscription, membership, access to a medical library, etc. you can take it from there.  I've grouped them together by journal for easier searching.

PEDIATRICS

Effect of Late-Preterm Birth and Maternal Medical Conditions on Newborn Morbidity Risk

"Late-Preterm" Infants: A Population at Risk

Optimizing Care and Outcome for Late-Preterm (Near-Term) Infants: A Summary of the Workshop Sponsored by the National Institute of Child Health and Human Development

Perinatal Outcomes Associated With Preterm Birth at 33 to 36 Weeks’ Gestation: A Population-Based Cohort Study

Preterm Infants as Young Adults: A Swedish National Cohort Study



New England Journal of Medicine

Long Term Medical and Social Consequences of Preterm Birth


Journal of Pediatrics

Differences in Mortality between Late-Preterm and Term Singleton Infants in the United States, 1995–2002


Morbidity and Mortality in Late-Preterm Infants: More than Just Transient Tachypnea!
, editorial to preceding article

Increased Risk of Adverse Neurological Development for Late Preterm Infants

Late Preterm Birth: Appreciable Risks, Rising Incidence, editorial to preceding article

School Outcomes of Late Preterm Infants: Special Needs and Challenges for Infants Born at 32 to 36 Weeks Gestation

School Outcome in Late Preterm Infants: A Cause for Concern
, editorial to preceding article


Clinics in Perinatology

The Relationship Between Cesarean Delivery and Gestational Age Among US Singleton Births
Epidemiology of Late Preterm (Near-Term) Births.  Raju TNK. December 2006 (Vol. 33, Issue 4, Pages 751-763)

Emergency Department Visits and Rehospitalizations in Late Preterm Infants.  Jain S. et al. 
December 2006 (Vol. 33, Issue 4, Pages 935-945)

Feeding Problems in the Late Preterm Infant
.  Adamkin D.  December 2006 (Vol. 33, Issue 4, Pages 831-837)

Elective Cesarean Section and Induction and Their Impact on Late Preterm Births.  Fuchs K., et al.
December 2006 (Vol. 33, Issue 4, Pages 793-801)


UPDATE - These Articles Hot Off The Press - Updated 04/2009

The Prognosis for Spontaneous Labor in Women With Uncomplicated Term Pregnancies: Implications for Cesarean Delivery on Maternal Request.

Decreasing Elective Deliveries Before 39 Weeks of Gestation in an Integrated Health Care System.

Surgeon General's Conference on the Prevention of Preterm BirthOfficial Publication in the Green Journal of the Report from the Surgeon General's Conference reference above.

Preterm Birth: An Enigma and a Priority. Editorial by Associate Editor, Catherine Spong, MD, to above report from Surgeon General's Conference.

Labor Induction Process Improvement: A Patient Quality-of-Care Initiative.

Obstetricians' Rising Liability Insurance Premiums and Inductions at Late Preterm Gestations.



Back to the Basics - Science That Is

For those of you interested in learning more about the background of Preterm Birth, check out the slide presentations available on the March of Dimes website for health care professionals as part of their Continuing Education Curriculum.  Slide Presentations include:

- Epidemiology and Biology of Preterm Birth
- Pathophysiologic Pathways to Preterm Birth
- Employing Systems-Based Practice for Patient-Centered Care
- The State of Research in Preterm Birth
- Management of Preterm Labor
- Management of Preterm Premature Rupture of Membranes

check it out here:  Continuing Education: The Compendium on Preterm Birth



Post-test

Congratulations, you have made it this far!  Please follow the link below to take the post-test, and see how much you've learned.  Answers to the post-test (which, you guessed it, is basically the same as the pretest) can be found below.  Feel free to read these over to find out anything you might have missed, or come back to the answers anytime just to refresh your memory on the facts. 

http://www.quibblo.com/quiz/7ZoRQRa/Post-test


Answers to the Post-test

Please see the answers to the post-test below, you can view it as a Word Doc or a PDF file.  All answers can be found in the presentation "Late Preterm Birth - What YOU Need to Know".

Answers to Post Test - Word
File Size: 121 kb
File Type: doc
Download File

Answers to Post Test - PDF
File Size: 154 kb
File Type: pdf
Download File



Disclaimer:  This site is for educational purposes only, and does not constitute medical advice.  Always seek medical advice from your health care provider.  The information on this site reflects current scientific information at the time of its initial publication to the web.