Interpretation of Gestational Ages

  1. The dilemma I have incurred is a definition for < 32 weeks gestation! It appears there can be more thatn 1 interpretation... Could I get some interpretations along with the city/country you are replying from.
    Thanks for the help!
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  2. 11 Comments

  3. by   Jolie
    Quote from Pitter Pat
    The dilemma I have incurred is a definition for < 32 weeks gestation! It appears there can be more thatn 1 interpretation... Could I get some interpretations along with the city/country you are replying from.
    Thanks for the help!
    I'm not sure what is open to intrepretation here. The phrase you have written means less than or equal to 32 weeks gestation. A baby born at this age would be 8 weeks shy of its due date and be premature.

    I'm from the Chicago area.
  4. by   dawngloves
    I may be a little dense, but what exactly are you defining?
  5. by   Pitter Pat
    Quote from dawngloves
    I may be a little dense, but what exactly are you defining?
    The real question is whether < 32 weeks gestation includes up to 32 weeks and 6 days or if the actual cut off is 32 weeks and 0 days and younger...
    I say the latter but apparently there is some disagreement!
  6. by   fergus51
    I would've said anything up to 33 weeks, so yes, 32 and 6 is included.
  7. by   Pitter Pat
    Quote from fergus51
    I would've said anything up to 33 weeks, so yes, 32 and 6 is included.
    Thanks for the feedback...Can you tell me what city/country you are from?
  8. by   fergus51
    Toronto, Canada. I only say that because 32 and 6 is still 32 weeks.
  9. by   llg
    I have lived in many areas of the U.S. and been a NICU nurses since the late 1970's, so this answer is not specific to any one time or place.

    Traditionally, in strict scientific circles (and for research purposes) a pregnant woman does not reach the next "week" until she actually reaches that week. For example, she becomes "33 weeks" on the day she hits "33 weeks, 0 days." "32 weeks, 6 days" is still counted as "32 weeks" for research purposes. People who use this interpretation do so to be consistent with the protocols that were probably used in the research upon which they base their practice.

    However, it is not uncommon for people providing patient care -- who may not need a strict, official operational definition for research purposes -- to treat someone who is "almost" another week further along a little differently (i.e. "and x weeks and 6 days") as if they had reached the next number of weeks. The rationale for that approach is that development doesn't suddenly jump from one level to the next when the calendar says another week has passes, but rather progresses gradually and continuously.

    Which approach is chosen is not so much a georgraphical difference ... but rather a difference based on the philosophical approach of the practitioner and/or the person who taught the practitioner. Do they want to be a little more conservative in the G.A. assessments and be more in line with most of the research? ... or do they want to "give the fetus credit" for the development he/she achieved throughout the week.

    I hope that clarifies a little how there has come to be different interpretations. It's one more reminder that clinical practice (be it nursing or medicine) is an art ... and it is based on philosophy ... as well as a science.

    llg
  10. by   mermom
    I have a couple of questions regarding this issue.

    I have seen some references to the effect that anything over 34 weeks as being "preterm, not premature". Is this ever accurate? And is there really a differentiation between preterm and premature in the field of neonatology? I realize the literal meanings of each word are self-evident (premature = before maturity, preterm = before term), but there has always been debate over this matter of symantics within the preemie community.

    Also, I'm hearing some references regarding the use of 37 weeks vs 40 to calculate prematurity. For instance, if a baby is born at 34 weeks, would it ever be appropriate to say that (s)he was "actually" only 3 weeks premature?

    Wen
    preemie mom and NICU nurse fan
  11. by   llg
    The standard GA assessment tool is considered to have a "plus or minus 2 weeks" margin of error. That is based on the orignial research that established the rating scales. So ... anything between 38 and 42 weeks could actually be a "term" baby because a baby who scored a 38 on the scale might actually be a 40-week baby. However, that same baby could also truly be 36 weeks -- so, you have to be careful when drawing conclusions and/or calling a that baby a full term baby.

    People (particularly people without a whole lot of experience in GA assessment) should be very hesitant to stretch or bend the grading criteria and/or use of the terminology. The overwhelming majority of people should stick to the research findings and the strict definitions.

    Here's another tidbit... I don't know the current standards/definitions, but for a long time the American Academy of Pedicatrics considered term to be 37-42 weeks because the reesearch done in the US showed that most 37-weekers had outcomes as good as those in the 38-42 range. However, the World Health Organization's official definition was that term was from 38-42 weeks because the positive outcomes for 37-weekers was not world-wide and also because their experts felt that the 37-weekers who had good outcomes in the US were not truly term babies, they were "almost" term babies who had good outcomes because of the Mom's good nutrition and the availability of good OB/Peds care.

    I think this is a good example of why you really need to study the science of something to understand it and not just take what someone tells you as being the whole story. Even something as "old" and commonplace as gestational age assessment includes lots of obscure little aspects and twists and turns that are not apparant at first glance.

    llg
  12. by   gladtobeOB
    Hi, I am from Pa and we would say the baby is 32 and6/7 weeks (7days a week and he is on the 6 th day of 7 in a week) weird I know, I'm just getting on to what they are refering too.
  13. by   Tiki_Torch
    I'd first like to thank llg for the wonderful posts on this subject!!! You always have clear insight for us!

    To answer the question at hand..."The real question is whether < 32 weeks gestation includes up to 32 weeks and 6 days or if the actual cutoff is 32 weeks and 0 days and younger."...

    I have worked in several southeastern states and each place has spoken of gestational age in the same way. If a baby is 31 0/7 up to 31 6/7 he is called a 31 weeker; he becomes a 32 weeker on the first day of being 32 weeks (32 0/7). Therefore, it would not really be possible to be < 32 weeks since the baby is either 31 6/7 or he is 32 0/7. (A baby could not be both less than and equal to 32 weeks.) Does this make any sense?

    It can become very confusing!!!

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