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Long-term digestive hospitalizations of premature infants (besides necrotizing enterocolitis): is there a critical
Ofir Ohana1, Tamar Wainstock2, Eyal Sheiner3
1Faculty of Health Sciences, Joyce and Irving Goldman Medical School, Ben Gurion University of the Negev, Beer-Sheva, Israel.
Insights
Preterm birth significantly increases long-term digestive issues in infants. Infants born at 28 weeks gestation face the highest risk of digestive morbidity, highlighting prematurity as a key factor.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Epidemiology
Background:
- Prematurity is a known concern for infant health.
- Long-term digestive morbidity in preterm infants requires further investigation.
- Identifying critical thresholds for prematurity is essential for risk assessment.
Purpose of the Study:
- To determine a critical gestational age threshold for long-term digestive morbidity in preterm infants.
- To analyze the association between the degree of prematurity and digestive health outcomes.
- To quantify the risk of digestive morbidity based on gestational age.
Main Methods:
- Population-based cohort analysis of infants born preterm.
- Categorization of infants into four groups based on gestational age.
- Utilized ICD-9 codes for defining digestive morbidity hospitalizations.
- Kaplan-Meier survival curves and Cox proportional hazards models were employed.
Main Results:
- Preterm infants experienced significantly higher rates of digestive morbidity hospitalizations compared to term infants.
- A decreasing gestational age correlated with a higher cumulative incidence of long-term digestive morbidity (Log rank p < 0.001).
- Infants born at 28 weeks gestation exhibited the highest risk; very preterm and moderate-to-late preterm birth were independent risk factors.
Conclusions:
- Preterm delivery is an independent risk factor for long-term digestive morbidity.
- Gestational age of 28 weeks serves as a critical cutoff for significant digestive morbidity.
- Early identification and management of risks associated with prematurity are crucial.
Background:
In this study we sought to ascertain a critical threshold of the degree of prematurity and long-term digestive morbidity of the offspring.
Methods:
A population-based cohort analysis was conducted, comparing long-term incidence of digestive morbidity in infants born preterm. Cases were divided into four groups according to the extremity of prematurity. Digestive morbidity included hospitalizations involving a predefined set of ICD9 codes. A Kaplan-Meier survival curve was constructed to compare cumulative incidence of digestive morbidity. A Cox proportional hazards model was used to control for confounders.
Results:
During the study period 220,563 patients met the inclusion criteria. Offspring born preterm had significantly more hospitalizations due to digestive morbidity compared to term offspring. The Kaplan-Meier survival curve demonstrated significant higher cumulative incidence of long-term digestive morbidity of the offspring with decreasing gestational age (Log rank p < 0.001). The risk was highest at 28 weeks gestation. Using a Cox proportional hazards model, being born at very and moderate to late preterm birth was independently associated with long-term digestive morbidity.
Conclusion:
Preterm delivery is an independent risk factor for long-term digestive morbidity of the offspring. In our population, 28 weeks gestation is the critical cut-off for pronounced digestive morbidity.
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