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Medical Needs of Very-Low-Birth-Weight Preterm Infants Post-Discharge: A Population-Based Study in Taiwan
Jui-Hsing Chang, Chia-Huei Chen1,2,3, Chun-Chih Peng1,2
1Division of Neonatology, Department of Pediatrics, MacKay Children's Hospital, Taipei City, Taiwan.
Insights
Very-low-birth-weight (VLBW) infants require significant ongoing medical care, including home oxygen therapy and rehabilitation, up to age 2. Coordinated follow-up is crucial for addressing their developmental and medical needs.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Developmental Pediatrics
Background:
- Very-low-birth-weight (VLBW) infants represent a vulnerable population with complex medical needs post-discharge.
- Understanding their long-term outcomes and healthcare utilization is critical for optimizing care.
- This study investigates the 2-year outcomes and medical requirements of VLBW infants.
Purpose of the Study:
- To explore the outcomes of VLBW infants at a corrected age of 2 years.
- To assess the home use of medical assistive devices among these infants.
- To identify the interdisciplinary medical needs of VLBW infants.
Main Methods:
- Utilized data from the Taiwan Premature Infant Follow-up Network (TPFN) (2011-2017).
- Analyzed perinatal, neonatal, and 2-year follow-up data.
- Investigated medical needs at discharge, outcomes, healthcare service utilization, and referrals.
Main Results:
- 10.2% of VLBW infants received home oxygen therapy (HOT) at discharge, particularly those with chronic lung disease (26.6%).
- 6.5% utilized home monitoring devices.
- At 2 years corrected age, common needs included rehabilitation (34.5%) and early intervention services (16.5%).
Conclusions:
- VLBW infants have substantial post-discharge healthcare needs, including HOT, rehabilitation, and early intervention.
- Coordinated outpatient care and long-term follow-up are essential for managing developmental and medical challenges.
- These findings underscore the importance of comprehensive support for VLBW survivors.
Abstract:
Introduction: The aim of this study was to explore the outcomes, home use of medical assistive devices, and interdisciplinary medical needs of very-low-birth-weight (VLBW) infants at a corrected age of 2 years.
Methods:
Analyses were performed using perinatal, neonatal, and 2-year follow-up data from VLBW infants registered in the Taiwan Premature Infant Follow-up Network (TPFN) between 2011 and 2017. Basic information, survival, and disease conditions during hospitalization were recorded. Medical needs at discharge, outcomes at a corrected age of 2 years, active involvement in outpatient healthcare services, and referrals were investigated.
Results:
From 2011 to 2017, a total of 9,243 VLBW preterm neonates were enrolled in the TPFN. Of these neonates, 140 had severe congenital anomalies, 8,044 survived to discharge, and 6,150 returned for follow-up evaluation. At discharge, 10.2% of infants received home oxygen therapy (HOT), and 6.5% used home monitoring devices. Among the infants diagnosed with chronic lung disease, 26.6% received HOT. At a corrected age of 2 years, the most common interventions and recommended referrals were rehabilitative treatments (34.5%), followed by early intervention system services (16.5%), ophthalmology/otolaryngology management (4.4%), neurological follow-up (4.1%), and mental health assessment and treatment (2.5%).
Conclusion:
After hospital discharge, VLBW preterm infants exhibit substantial healthcare needs, with significant demands of HOT, rehabilitation, and early intervention services by a corrected age of 2 years. These findings highlight the importance of coordinated outpatient care and long-term follow-up to address the developmental and medical challenges faced by this vulnerable population.
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