When a pregnancy nears its end, the timing of delivery often causes confusion. Many people wonder if a baby born at 38 weeks is considered premature, a term historically applied to any birth before the traditional due date. Modern medical classifications have refined this understanding, recognizing that even a few weeks can significantly impact a newborn’s readiness for life outside the womb. This distinction guides the specific care a 38-week-old newborn receives.
Defining Gestational Age
A birth at 38 weeks is not classified as premature; that designation is reserved for infants born before 37 weeks of gestation. Medical organizations, such as the American College of Obstetricians and Gynecologists (ACOG), established new gestational age definitions to provide more accurate data and reflect varying neonatal outcomes. These categories replaced the older, broader term of “full term,” which once encompassed births from 37 to 42 weeks.
The current system divides the end of pregnancy into specific windows. Preterm birth occurs before 37 weeks. A birth at 38 weeks falls into the “Early Term” category, spanning 37 weeks 0 days through 38 weeks 6 days. The optimal window, known as Full Term, is 39 weeks 0 days through 40 weeks 6 days. Deliveries beyond this are designated Late Term (41 weeks 0 days through 41 weeks 6 days) or Post Term (42 weeks 0 days and beyond).
Why 38 Weeks is Considered Early Term
The “Early Term” designation exists because newborns delivered at 38 weeks face slightly higher risks compared to those born at 39 weeks. The final weeks in utero are periods of rapid maturation, particularly for the brain and lungs. For example, the fetal brain increases in weight by approximately one-third between 35 and 39 weeks as crucial neural connections and myelination are still forming.
Lung development also continues until the end of pregnancy, increasing the chance of minor respiratory issues for 38-week infants. Specific conditions seen more frequently include transient tachypnea of the newborn (TTN), a temporary breathing difficulty caused by retained fluid. These infants also show higher rates of jaundice, feeding difficulties, and problems maintaining body temperature compared to their Full Term counterparts.
Common Factors Leading to Early Term Birth
Delivery at 38 weeks occurs either spontaneously or is scheduled due to a medical necessity where continued pregnancy is riskier than early delivery. Current medical guidelines strongly discourage elective inductions or cesarean sections before 39 weeks without a clear medical reason.
Maternal health conditions often necessitate an Early Term delivery, including hypertensive disorders like pre-eclampsia or poorly controlled chronic hypertension, and certain cases of gestational diabetes. Fetal conditions, such as confirmed fetal growth restriction (FGR), may also prompt delivery between 38 and 39 weeks. Uncomplicated dichorionic twin pregnancies are also often delivered during this Early Term window.
Monitoring and Care for the Early Term Infant
Infants born at 38 weeks generally have excellent long-term outcomes, but they require close observation during their initial hospital stay due to physiological immaturity. A primary concern is regulating blood sugar; these newborns have lower glycogen reserves and are at risk for hypoglycemia, necessitating frequent glucose checks. Maintaining body temperature is also a challenge because they have less insulating body fat, often requiring immediate skin-to-skin contact or placement in a warmer.
Feeding support is often required, as Early Term infants may be sleepier or struggle to coordinate the suck-swallow-breathe reflex effectively. Medical staff closely monitor for jaundice (hyperbilirubinemia), which can be more pronounced due to still-maturing liver function. Parents are advised on signs to watch for and are usually scheduled for a follow-up appointment within 24 to 48 hours of discharge to ensure proper weight gain and resolution of complications.