Delivering a baby at 36 weeks, which is known as late preterm, can happen spontaneously or may require induction. A doctor might induce a pregnancy for a variety of reasons, including preterm labor, severe preeclampsia, placental problems, fetal growth restriction, or gestational diabetes.
The American College of Obstetricians and Gynecologists (ACOG) do not recommend voluntarily inducing labor before 39 weeks gestation unless there is a medical need to do so.
Most babies born at 36 weeks are generally healthy. However, there are some risks that people should be aware of.
Is 36 weeks gestation premature?
Current guidelines recommend that a baby stays in the womb for 39 weeks.
According to ACOG:
- a gestational age below 28 weeks is extremely preterm
- a gestational age of 28 – 32 weeks is very preterm
- a gestational age between 32 and 37 weeks is moderate to late preterm
- a gestational age between 34 and 36 weeks is late preterm
- a gestational age between 37 and 38 weeks is early term
- a gestational age of 39 weeks and beyond is full-term
According to March of Dimes, late preterm deliveries accounted for 6.9 percent of all live births in the United States in 2015.
Previously, ACOG considered 37 weeks as a full-term pregnancy. However, because many babies born at 37 weeks experienced complications, they changed their guidelines. Now, the recommended time for a baby to stay inside the womb is at least 39 weeks unless medically indicated.
Survival rate
Some infants born in the late preterm period are physiologically and developmentally immature when compared to full-term infants and are at higher risks of sickness and death. Risk of infant death or sickness decreases significantly with each passing week of gestation.
Understanding which babies are most at risk for sickness and death can help healthcare providers prepare for possible complications.
According to a 2012 report in Seminars in Fetal and Neonatal Medicine, between 2006–2008 in the U.S., the rate for infant death among babies born 34 to 36 weeks was 7.1 per 1000 births. In comparison, the mortality rate for babies born 32-33 weeks was 16.2 per 1000 live births.
Impact on development
Babies born at 36 weeks are more at risk for developmental problems, both physically and mentally, when compared to their full-term counterparts.
Babies born at 36 weeks gestation are at a higher risk than babies born at term for the following:
- cerebral palsy
- poor school performance
- need for early intervention services
- special education needs
- behavioral and psychiatric problems
According to research posted to the American Journal of Perinatology, late preterm children of preschool age were less able to follow directions and perform memory tasks when compared to their peers born at full-term.
Another study revealed that late preterm infants showed reduced developmental outcomes at 9 months of age when compared to full-term infants. However, these differences were not apparent at 2 years old but reemerged in kindergarten children concerning preschool reading, preschool math, and kindergarten reading.
Being aware of these complications can help parents, teachers, and healthcare providers target surveillance and early intervention.
What are the potential complications?
Complications of being born at 36 weeks include a low birth weight.
Although babies born at 36 weeks are generally healthy and are at lower risk for health complications than babies who are born earlier than this, they may still experience some health issues.
Sometimes, it is difficult to identify whether the complication is due to early birth itself or a medical reason that triggered the early delivery.
Complications can include the following:
- respiratory distress syndrome (RDS)
- sepsis
- patent ductus arteriosus (PDA)
- jaundice requiring phototherapy
- low birth weight
- low blood sugar levels
- difficulty regulating temperature
- feeding difficulties
- death
As a result of these complications, babies may need to be admitted to a neonatal intensive care unit (NICU) or readmitted to the hospital after going home.
Takeaway
There is a variety of medical reasons why a baby is born at 36 weeks. Late preterm birth is most often due to a woman going into labor early. However, a medical condition that the mother or baby has developed may also cause preterm delivery.
Doctors recommend that babies remain inside the womb until at least 39 weeks, if possible, for the best outcomes.
Babies born at 36 weeks may face challenges, such as health complications and developmental delays into childhood.
Being aware of these difficulties allows the parents and doctor to put a plan in place.