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Hospital admissions in the first year of life in very preterm infants
Insights
Hospital readmissions are common for very preterm infants. Key risk factors for medical readmission include Aboriginal race, male sex, and chronic lung disease (CLD), while breastfeeding offers protection.
Area of Science:
- Neonatalogy
- Pediatric Health Outcomes
- Public Health
Background:
- Infants born very preterm (< 33 weeks' gestation) face significant health challenges post-discharge.
- Understanding readmission patterns is crucial for improving long-term outcomes in this vulnerable population.
Purpose of the Study:
- To analyze the incidence and risk factors for hospital readmissions up to one year of age in very preterm infants.
- To differentiate risk factors for medical versus surgical readmissions.
Main Methods:
- A prospective cohort study of very preterm infants born in Western Australia.
- Data collected included perinatal factors, chronic lung disease (CLD), and readmission details.
- Statistical analysis identified risk factors associated with readmissions.
Main Results:
- 42% of infants experienced 443 readmissions (370 medical, 73 surgical).
- Medical readmission risks included Aboriginal race, male sex, and CLD; breastfeeding was protective.
- Surgical readmission risks included male sex, lower gestation, severe hyaline membrane disease, severe CLD, and low birthweight.
Conclusions:
- Hospital readmission is a frequent occurrence following very preterm birth.
- Risk factors for medical and surgical readmissions are distinct, with CLD being a common factor for both.
- Identifying these risk factors can inform targeted interventions to reduce readmissions.
Objective:
To analyse hospital readmissions to 1 year in infants < 33 weeks' gestation.
Study Design:
Cohort of very preterm infants born in Western Australia.
Methods:
Parental social class, history of asthma, race, gestational age, birthweight, sex, severity of respiratory disease and oxygen requirement at 28 days chronic lung disease (CLD), 36 weeks and term, maternal smoking, cohabitation with siblings, breast-feeding duration and hospital readmissions were recorded prospectively.
Results:
Data were available for 538 of 560 (96%) infants discharged. Eight died in the first year. Two hundred and twenty-five infants (42%) had 443 readmissions, of which 370 were medical and 73 surgical. Risk factors for medical readmission were Aboriginal race, male sex and CLD. Breast-feeding was protective. Risk factors for surgical admission were male sex, lower gestation, severe hyaline membrane disease, severe CLD and birthweight < 10th centile.
Conclusions:
Readmission is common after very preterm birth. Risk factors for medical and surgical admission differ with CLD being the only perinatal factor associated with both medical and surgical admission.
