Very interesting and informative review of the current knowledge on moderately and late preterm birth by Dr Boyle. It is one of my favourite topics and I especially appreciated the discussion afterwards.
Postponing preterm delivery is something we often wish for from the neonatal aspect, but it is difficult to achieve for many reasons. And, to be honest; we don’t really know if the late/moderately preterm infants would do better, had their birth been postponed into term gestations. There is a sort of confounding by indication built into this relationship. However, many of us believe that a prolonged pregnancy would be beneficial. A large RCT would answer the question but there are many obstacles to the design of such a study.
As always, socioeconomic factors end up as important risk factors for both preterm birth and impaired outcome. I agree with Dr Boyle that this may an important area to adress.
I’d be happy to read your further comments on this.
Thanks Maria for a thoughtful comment! Some fancy observational research might (possibly) overcome some difficulties. But, I agree fully that confounding by indication is a tricky issue very hard to handle.