Admissions and Emergency Visits by Late Preterm Singletons and Twins in the First 5 Years: A Population-Based Cohort
Tetsuya Isayama1,2,3, Daria O'Reilly1,4, Joseph Beyene1
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Insights
Late preterm infants, born between 34 and 36 weeks, experienced more hospital admissions and emergency visits than full-term infants up to age 5. However, late preterm twins had fewer admissions than singletons.
Area of Science:
- Neonatal and Developmental Pediatrics
- Public Health and Epidemiology
- Healthcare Outcomes Research
Background:
- Late preterm infants (34-36 weeks gestation) represent a significant proportion of births and may face distinct health challenges compared to term infants.
- Understanding the long-term healthcare utilization of late preterm infants is crucial for resource allocation and targeted interventions.
Purpose of the Study:
- To compare the rates of hospital admissions and emergency visits in late preterm infants versus term infants during the first five years of life.
- To investigate potential differences in healthcare utilization between late preterm singletons and twins.
Main Methods:
- A population-based cohort study utilizing a Canadian health administrative database.
- Inclusion of all live births between 34 and 41 weeks' gestation from 2002 to 2012.
- Comparison of admissions and emergency visits from birth up to 5 years, with adjustments for maternal and infant characteristics.
Main Results:
- Late preterm infants (n=75,364) had significantly higher admission rates than term infants (n=1,316,931) in both singleton and twin births up to age 5.
- The adjusted incidence rate ratio for admissions was 1.46 (95% CI: 1.42-1.49) for late preterm singletons and 1.21 (95% CI: 1.11-1.31) for late preterm twins.
- Emergency visits were consistently more frequent in late preterm infants compared to term infants across all observed periods.
Conclusions:
- Late preterm infants exhibit increased healthcare utilization, including hospital admissions and emergency visits, throughout the first five years post-discharge.
- While late preterm infants generally have higher admission rates, late preterm twins demonstrated fewer admissions compared to late preterm singletons.
Objective:
To compare admission and emergency visits of late preterm (340/7-366/7 weeks) versus term infants (370/7-416/7 weeks) in the first 5 years.
Study Design:
This population-based cohort study included all singletons and twins born alive at 340/7 to 416/7 weeks' gestation registered in a health administrative database in Ontario, Canada, between April 1, 2002 and December 31, 2012. Admissions and emergency visits from initial postnatal discharge to 5 years were compared between late preterm and term infants adjusting for maternal and infant characteristics.
Results:
A total of 1,316,931 infants (75,364 late preterm infants) were included. Late preterm infants had more frequent admissions than term infants in the first 5 years in both singletons (adjusted incidence rate ratio [95% confidence interval] = 1.46 [1.42-1.49]) and twins (1.21 [1.11-1.31]). The difference in admissions between late preterm and term infants were smaller in twins than singletons and decreased with children's ages. Twins had less frequent admissions than singletons for late preterm infants, but not for term infants. The emergency visits were more frequent in late preterm than term infants in all the periods.
Conclusion:
Admissions and emergency visits were more frequent in late preterm than term infants through the first 5 years. Admissions were less frequent in late preterm twins than singletons.
