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Prematurity-associated morbidity during the first two years of life. A population-based study
A Hakulinen1, K Heinonen, V Jokela
1Children's Hospital, Kuopio, Finland.
Insights
Preterm infants experienced a 30% readmission rate within two years, primarily due to respiratory infections and surgical issues. Intrauterine growth retardation and male sex increased readmission risk for these vulnerable infants.
Area of Science:
- Pediatrics
- Neonatology
- Public Health
Background:
- Postneonatal morbidity in preterm infants is a significant concern.
- Understanding readmission patterns is crucial for improving long-term outcomes.
Purpose of the Study:
- To analyze two-year patterns of postneonatal morbidity in liveborn preterm infants.
- To identify risk factors for hospital readmission in this population.
Main Methods:
- Retrospective cohort study of 612 preterm infants born in Kuopio, Finland (1978-1982).
- Data collected on chronic and non-chronic morbidities and readmission rates over two years.
- Analysis of neonatal treatment variables, gestational age, intrauterine growth retardation (IUGR), and sex as risk factors.
Main Results:
- Overall readmission rate was 30%, with respiratory infections, surgical disorders (inguinal hernias), and neurological problems being common causes.
- Infants born at or before 33 weeks gestation had higher readmission rates, largely due to chronic prematurity-associated conditions.
- Preterm infants without chronic disabilities showed similar readmission rates regardless of gestational age.
- Neonatal treatment variables were poor predictors of readmission.
- Intrauterine growth retardation (IUGR) and male sex significantly increased the risk of subsequent readmission.
Conclusions:
- Readmission patterns in preterm infants are influenced by both chronic conditions and specific risk factors like IUGR and male sex.
- Gestational age alone is less predictive than the presence of chronic prematurity-associated conditions.
- Targeted interventions for IUGR and male preterm infants may reduce readmission rates.
Abstract:
Two-year patterns of postneonatal morbidity, both chronic and non-chronic, reported for all liveborn preterm infants (n = 612; malformations excluded) delivered in the province of Kuopio, Finland, between 1978 and 1982. The overall readmission rate was 30%, the commonest cause being respiratory infections, surgical disorders (inguinal hernias) and neurological problems. The higher readmission rate in preterms born at less than or equal to 33 weeks of gestation was due to a large proportion of children being admitted with chronic prematurity-associated conditions; preterms without chronic disabilities had similar rates of readmission irrespective of gestational age. Neonatal treatment variables were of little help in the identification of children requiring readmission after neonatal care. Instead, intrauterine growth retardation (IUGR) or being of the male sex significantly increased the risk of subsequent readmission.