Factor affecting length of stay in late preterm infants: an US national database study

Area of Science:

• Neonatalogy
• Pediatrics
• Health Services Research

Background:

• Late preterm infants represent a rapidly growing population in the United States.
• Understanding factors influencing their length of hospital stay (LOS) is crucial for resource management and care planning.
• Previous research has not fully elucidated the predictors of LOS in this specific demographic.

Purpose of the Study:

• To identify demographic and clinical factors associated with a length of hospital stay (LOS) greater than 3 days in late preterm infants.
• To compare the risks and influencing factors for LOS between infants born at 33-34 weeks and those born at 35-36 weeks gestation.

Main Methods:

• Analysis of a de-identified dataset (Nationwide Inpatient Sample Database) comprising 81,913 infants born between 33-36 weeks gestation (2007-2008).
• Length of hospital stay (LOS) was categorized as ≤3 days or >3 days.
• Bivariable and multivariable logistic regression models were employed to determine predictors of prolonged LOS.

Main Results:

• Only 42.7% of late preterm infants were discharged within 3 days.
• Factors significantly associated with LOS >3 days included: gestational age <35 weeks, birth weight <2500g, male sex, Cesarean delivery, and multiple gestation.
• Race, birth region, insurance payer, and clinical complications also impacted LOS, with greater influence observed in the 35-36 week gestation group.

Conclusions:

• Gestational age, birth weight, sex, delivery mode, multiple gestation, insurance payer, and birth region are significant determinants of LOS in late preterm infants.
• These factors exert a more pronounced effect on the length of hospital stay for infants born between 35-36 weeks gestation.
• The findings highlight the need for targeted interventions and resource allocation for late preterm infants, particularly those closer to full term.