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Early childhood respiratory morbidity according to gestational age at birth: A nationwide cohort study
Yishai Sompolinsky1, Michal Lipschuetz2, Malena Cohen-Cymberknoh3
1Department of Obstetrics & Gynecology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel.
Insights
Preterm birth survivors face significant long-term respiratory health issues, increasing healthcare utilization. This study quantifies the respiratory morbidity burden across all gestational ages in a large cohort.
Area of Science:
- Neonatal Medicine
- Public Health
- Respiratory Medicine
Background:
- Preterm birth survivors experience elevated short- and long-term respiratory morbidity, including chronic obstructive pulmonary disease and infectious diseases.
- Previous research indicates increased healthcare service utilization in early childhood for these infants.
- Limited large-scale studies have comprehensively assessed respiratory morbidity across the full spectrum of gestational age at birth.
Purpose of the Study:
- To quantify the healthcare burden associated with prematurity.
- To analyze respiratory morbidity across a large nationwide cohort.
- To investigate the impact of gestational age on respiratory health outcomes.
Main Methods:
- Analysis of 1,762,149 infants born in Israel (2010-2019).
- Data collected on gestational age, birth month/year, and infant sex.
- Calculation of hospitalization rates, length of stay, and emergency department visits per 1000 live births, stratified by gestational age.
- Use of Poisson regression to adjust for covariates.
Main Results:
- Preterm birth occurred in 6.43% of deliveries (n=109,405).
- A significant negative association was observed between gestational age at birth and respiratory morbidity.
- Increasing gestational age correlated with decreased respiratory hospitalization rates and shorter hospital stays, extending even beyond full term.
Conclusions:
- Preterm birth imposes a substantial and prolonged healthcare burden globally, extending from infancy into early childhood.
- These findings underscore the need for enhanced prevention and treatment strategies for preterm and early-term births.
- Stakeholders and professional organizations must prioritize interventions to mitigate the respiratory health consequences of prematurity.
Background:
Preterm birth survivors are at risk for short- and long-term respiratory morbidity. This includes increased rates of chronic obstructive pulmonary disease and infectious morbidity. Previous studies showed increased utilization of healthcare services throughout early childhood. However, only a few large-scale studies showed the effect on respiratory morbidity throughout the full spectrum of gestational age at birth. The aim of this study was to show the healthcare burden associated with prematurity, in a large nationwide cohort.
Study Design:
Data regarding gestational age at birth, month and year of birth, and infant sex were gathered for all 1,762,149 infants born in Israel between January 1, 2010, and December 31, 2019. Rates of hospitalization, length of hospitalization, and emergency department visits were calculated per 1000 live births and stratified by gestational age. Poisson regression was constructed to adjust for infant sex, year and month of birth.
Results:
Preterm birth occurred in 6.43 % of deliveries (n = 109,405). A negative association was found between gestational age at birth and respiratory morbidity. As gestational age at birth advances, rates of respiratory hospitalization decrease, and length of hospitalization shortens. This association continues even after full term is reached.
Conclusion:
The short- and long-term effect of preterm birth poses a significant burden on healthcare systems globally, not only at birth or in infancy, but well into early childhood. These results are a call for action to stakeholders and professional organizations to increase efforts in preventing and treating preterm and early term labor.
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