Respiratory distress in late-preterm neonates: from controversy to consensus – a survey of regional advisory boards and neonatologists in France

Objective Late-preterm neonates present with more complications at birth than full-term neonates. The care of these infants is sometimes controversial. Our study aims at examining the practices of French neonatologists and compares them to the literature.Design Regional advisory boards discussed a c...

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Main Authors: Elie Saliba, Delphine Mitanchez, Jean Michel Hascoet, Yoni Athea
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Paediatrics Open
Online Access:https://bmjpaedsopen.bmj.com/content/9/1/e003557.full
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author Elie Saliba
Delphine Mitanchez
Jean Michel Hascoet
Yoni Athea
author_facet Elie Saliba
Delphine Mitanchez
Jean Michel Hascoet
Yoni Athea
author_sort Elie Saliba
collection DOAJ
description Objective Late-preterm neonates present with more complications at birth than full-term neonates. The care of these infants is sometimes controversial. Our study aims at examining the practices of French neonatologists and compares them to the literature.Design Regional advisory boards discussed a clinical case with four categories of questions: the risk of term-related respiratory distress (RD), the indication for antenatal corticosteroid therapy, neonatal care at delivery and the use of surfactant. An anonymous survey covering the same question categories was also sent to French neonatology departments.Results For the risk of RD, the boards’ responses were somewhat unclear. Conversely, the survey highlighted the association between high risk of RD and low term of birth, which is in agreement with the literature. The boards noted that, in the absence of official recommendations, they would not advise using antenatal corticosteroids. However, the survey recommended their use in cases of threatened prematurity (32%). For neonatal care at delivery, the boards and survey recommended the standard use of continuous positive airway pressure (CPAP) as advised in the literature. Lastly, the boards and survey agreed that surfactant therapy is part of usual care. Published recommendations do not support its systematic use except when RD is present.Conclusion This study confirms that late-preterm infants have an often-underestimated vulnerability. Morbidity is inversely correlated with gestational age, and caution is required over the place of birth. Antenatal steroid treatment remains controversial. There is consensus over the use of CPAP at delivery and of surfactant as early curative therapy.
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spelling doaj-art-4dbb38ddc81c470a999dedda5ec57d7d2025-08-20T03:29:35ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722025-06-019110.1136/bmjpo-2025-003557Respiratory distress in late-preterm neonates: from controversy to consensus – a survey of regional advisory boards and neonatologists in FranceElie Saliba0Delphine Mitanchez1Jean Michel Hascoet2Yoni Athea3Société Française de Néonatalogie, Tours, FranceService de néonatologie, CHRU de Tours, Hôpital Bretonneau, Tours, FranceNeonatologie, Centre Hospitalier Régional Universitaire de Nancy Maternité Régionale Adolphe Pinard, Nancy, FranceChiesi SA France, Bois-Colombes, FranceObjective Late-preterm neonates present with more complications at birth than full-term neonates. The care of these infants is sometimes controversial. Our study aims at examining the practices of French neonatologists and compares them to the literature.Design Regional advisory boards discussed a clinical case with four categories of questions: the risk of term-related respiratory distress (RD), the indication for antenatal corticosteroid therapy, neonatal care at delivery and the use of surfactant. An anonymous survey covering the same question categories was also sent to French neonatology departments.Results For the risk of RD, the boards’ responses were somewhat unclear. Conversely, the survey highlighted the association between high risk of RD and low term of birth, which is in agreement with the literature. The boards noted that, in the absence of official recommendations, they would not advise using antenatal corticosteroids. However, the survey recommended their use in cases of threatened prematurity (32%). For neonatal care at delivery, the boards and survey recommended the standard use of continuous positive airway pressure (CPAP) as advised in the literature. Lastly, the boards and survey agreed that surfactant therapy is part of usual care. Published recommendations do not support its systematic use except when RD is present.Conclusion This study confirms that late-preterm infants have an often-underestimated vulnerability. Morbidity is inversely correlated with gestational age, and caution is required over the place of birth. Antenatal steroid treatment remains controversial. There is consensus over the use of CPAP at delivery and of surfactant as early curative therapy.https://bmjpaedsopen.bmj.com/content/9/1/e003557.full
spellingShingle Elie Saliba
Delphine Mitanchez
Jean Michel Hascoet
Yoni Athea
Respiratory distress in late-preterm neonates: from controversy to consensus – a survey of regional advisory boards and neonatologists in France
BMJ Paediatrics Open
title Respiratory distress in late-preterm neonates: from controversy to consensus – a survey of regional advisory boards and neonatologists in France
title_full Respiratory distress in late-preterm neonates: from controversy to consensus – a survey of regional advisory boards and neonatologists in France
title_fullStr Respiratory distress in late-preterm neonates: from controversy to consensus – a survey of regional advisory boards and neonatologists in France
title_full_unstemmed Respiratory distress in late-preterm neonates: from controversy to consensus – a survey of regional advisory boards and neonatologists in France
title_short Respiratory distress in late-preterm neonates: from controversy to consensus – a survey of regional advisory boards and neonatologists in France
title_sort respiratory distress in late preterm neonates from controversy to consensus a survey of regional advisory boards and neonatologists in france
url https://bmjpaedsopen.bmj.com/content/9/1/e003557.full
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