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Discharge Age and Weight for Very Preterm Infants in Six Countries: 2012-2020

Erika M Edwards1,2,3, Lucy T Greenberg1,3, Jeffrey D Horbar1,2

  • 1Vermont Oxford Network, Burlington, Vermont, USA.

Neonatology
|January 17, 2023
PubMed

Insights

Infant intensive care outcomes improved, with longer postmenstrual age and higher discharge weight observed in some countries. However, care processes at discharge did not significantly change alongside these improvements.

Area of Science:

  • Neonatology
  • Pediatric Intensive Care
  • Perinatal Medicine

Background:

  • Infants born prematurely (24-29 weeks' gestational age) without congenital anomalies in the USA showed increased postmenstrual age and discharge weight between 2005-2018.
  • This trend prompted an investigation into whether similar changes were occurring internationally.

Purpose of the Study:

  • To evaluate trends in postmenstrual age, weight, and weight z-score at discharge for preterm infants across multiple countries.
  • To compare changes in infant outcomes and care processes in neonatal intensive care units (NICUs) internationally.

Main Methods:

  • Analysis of data from surviving infants (24-29 weeks' gestational age) without congenital anomalies admitted to Vermont Oxford Network hospitals.
  • Data collection spanned from 2012 to 2020 across Austria, Ireland, Italy, Switzerland, the UK, and the USA.

Main Results:

  • Significant increases in postmenstrual age at discharge were observed in Austria, Italy, and the USA.
  • Discharge weight and weight z-score increased significantly in several countries, including Austria, Ireland, Italy, and the USA.
  • Trends in discharge practices, such as feeding on human milk and use of cardiorespiratory monitors or oxygen, showed varied changes across nations.

Conclusions:

  • Postmenstrual discharge age and weight for very preterm infants have increased in some, but not all, participating countries.
  • Despite improvements in infant size and age at discharge, associated care processes at discharge did not demonstrate concurrent changes.
Abstract

Keywords:
Length of stayNeonatologyPreterm infantsUtilization

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