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Health Services Use by Late Preterm and Term Infants From Infancy to Adulthood: A Meta-analysis

Tetsuya Isayama1,2, Anne-Mary Lewis-Mikhael3, Daria O'Reilly4,5

  • 1Departments of Health Research Methods, Evidence, and Impact, isayama@air.ocn.ne.jp.

Pediatrics
|August 1, 2017
PubMed

Insights

Late-preterm infants face increased health service use, including hospital admissions for various conditions, throughout childhood and adolescence. This systematic review highlights their higher healthcare needs compared to full-term infants.

Area of Science:

  • Neonatal and Perinatal Medicine
  • Pediatric Health Services Research
  • Public Health

Background:

  • Late-preterm infants (born 34-36 weeks gestation) have elevated risks for health issues.
  • Health service utilization (HSU) in this population remains under-summarized.

Purpose of the Study:

  • To systematically review and synthesize literature on short- and long-term HSU in late-preterm infants compared to term infants.
  • To analyze HSU from infancy through adulthood post-hospital discharge.

Main Methods:

  • Comprehensive literature search of major medical databases (Medline, Embase, CINAHL, PsycINFO).
  • Inclusion of cohort and case-control studies comparing HSU (admissions, ED visits) between late-preterm and term infants.
  • Data extraction included study design, population, HSU outcomes, and effect estimates.

Main Results:

  • Fifty-two studies (50 cohort, 2 case-control) were included in the meta-analysis.
  • Late-preterm infants showed significantly higher all-cause hospital admissions across all age periods studied.
  • Increased cause-specific HSU for jaundice, infection, respiratory, asthma, and neurological/mental health issues was observed.

Conclusions:

  • Late-preterm infants exhibit higher risks for all-cause and specific health service utilization from infancy through adolescence.
  • Heterogeneity in study findings was partly attributed to variations in controlling for multiple births and term infant gestational age ranges.
Abstract

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