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Re-hospitalization in infants younger than 29 weeks' gestation in the EPIPAGE cohort
A Lamarche-Vadel1, B Blondel, P Truffer
1Research Unit on Perinatal Health and Women's Health, INSERM U149, Villejuif, France.
Insights
Extremely preterm infants face a high re-hospitalization risk, with nearly half readmitted during infancy. Chronic lung disease and household factors increase this risk, necessitating targeted surveillance post-neonatal discharge.
Area of Science:
- Neonatalogy
- Pediatric Health
- Public Health
Background:
- Improved survival rates for extremely preterm infants have emerged.
- Understanding post-discharge health risks is crucial for this population.
Purpose of the Study:
- To determine the re-hospitalization rate in extremely preterm infants.
- To identify factors associated with re-hospitalization after neonatal discharge.
Main Methods:
- A cohort of 376 infants born before 29 weeks gestation was analyzed.
- Data included child characteristics, neonatal course, post-discharge infection risks, and socio-demographics.
- Logistic regression models were used to calculate adjusted odds ratios for re-hospitalization.
Main Results:
- The re-hospitalization rate was 47.3%, with 55% of these for respiratory disorders.
- Chronic lung disease, discharge season (August-January), and living with young children were associated with higher re-hospitalization.
- Gestational age and neonatal hospitalization duration did not significantly impact re-hospitalization rates.
Conclusions:
- Infants born before 29 weeks have a substantial risk of re-hospitalization.
- Identifying high-risk infants at discharge can guide targeted surveillance strategies.
Aim:
To estimate the re-hospitalization rate of extremely preterm children during infancy and associated factors after the recent improvement in survival rates.
Method:
The cohort included all children born before 29 wk of gestation in nine French regions in 1997. All admissions between discharge from initial hospitalization and 9 mo after birth were considered. Factors studied included the child's characteristics at birth and during neonatal hospitalization, risk factors for infection after discharge and parents' socio-demographic characteristics. Adjusted odds ratios (aOR) for re-hospitalization for all reasons and for respiratory disorders were obtained from logistic regression models.
Results:
Of the 376 children, 178 were re-admitted at least once (47.3%; 95% CI: 42.3-52.4). Fifty-five percent of the hospitalized children were admitted at least once for respiratory disorders. The re-hospitalization rate was higher for children who had had chronic lung disease (aOR: 2.2; 95% CI: 1.3-3.7), those initially discharged between August and October (aOR: 2.5; 95% CI: 1.2-5.1) or between November and January (aOR: 3.2; 95% CI: 1.5-6.8), and children living with other children under six (aOR: 3.4; 95 %CI: 1.6-7.5). Re-hospitalizations were associated with neither gestational age nor the duration of neonatal hospitalization. Adjusted odds ratios for re-hospitalization for respiratory tract disorders were very similar to those for the overall hospitalizations.
Conclusion:
Infants born before 29 wk have a very high risk of re-hospitalization. The associated factors can help define high-risk groups at discharge from the neonatal unit who need special surveillance.
