Emily Oster

2 min Read Emily Oster

Emily Oster

Will a Baby Born at 37 Weeks Be OK?

Q&A on early term birth?

Emily Oster

2 min Read

Is there any data on outcomes for a baby induced at 37 weeks? I have a poor obstetrical history, which means it is medically appropriate to induce at 37 weeks. My doctor said her preference is to induce at 37 weeks, that she wouldn’t want me to go as far as 39, and that the decision is ultimately mine to make. From what I understand, the baby is considered full-term at 36 weeks and that the last four weeks are about weight gain and lung strengthening. But how crucial are these weeks to the baby’s overall health, at birth and long term? My doctor assured me that it was fine but that many people (irrationally?) feel they are being selfish by pushing the ejection button early and choosing to white-knuckle it through the last weeks.

—31 Weeks and Counting Every Minute

Until about a decade ago, the entire period from 37 to 42 weeks of gestation was considered “full term,” and there was little distinction made between births at various weeks. However, around 2011, the American College of Obstetricians and Gynecologists chose to distinguish within this span: 37 weeks and 0 days to 38 weeks and 6 days is now “early term,” 39+0 to 40+6 is “full term,” and 41+0 to 41+6 is “late term.”

The reason for this change was the recognition that complications are, on average, higher for babies at 37 and 38 weeks than for those born later. This paper is one large-scale analysis of this, in which the authors demonstrate that (for example) among babies born at 37 weeks, the share with NICU admission is 9.4%, versus 5.8% at 38 weeks and 5% at 39 weeks. The main issues are respiratory, since (as you note) lung development comes late.

A newborn infant holds a parent's thumb in a closeup.
Getty

Having said this: For births in this period — 37 weeks on — the vast majority of complications are minor, and NICU stays tend to be short unless there is another issue going on. This means that there are many circumstances in which other factors outweigh the small increase in risk. It sounds like you might well be in this situation. 

There isn’t an easy answer here, and the answer you do come up with should necessarily depend on the details of your history. One thing to note: It does look like outcomes at 38 weeks are very similar to those at 39 weeks, which might inform any decision to wait.

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