Preterm Birth and Risk of Health Service Use, Morbidity, and Medication Needs at 5 Years

Area of Science:

• Neonatal care and outcomes
• Pediatric health services research
• Population health

Background:

• Neonatal intensive care has advanced significantly.
• Premature birth continues to be a major cause of neonatal mortality and morbidity.
• Long-term health outcomes for preterm infants require ongoing investigation.

Purpose of the Study:

• To describe health service utilization, morbidity, and medication needs up to age 5 years in a contemporary cohort of children born preterm.
• To quantify the association between gestational age at birth and health outcomes in early childhood.

Main Methods:

• Population-based cohort study using linked administrative health and pharmacy data in British Columbia, Canada.
• Included 448,819 children born between 2004 and 2014 with 5-year follow-up.
• Analyzed gestational age at birth, health service use (hospitalizations, outpatient visits), morbidity diagnoses, and outpatient prescriptions.

Main Results:

• Children born preterm had higher hospitalization rates and outpatient visits compared to those born at 39-41 weeks' gestational age.
• Preterm birth was associated with increased risks of respiratory, endocrine, gastrointestinal, kidney, neurodevelopmental, and sleep disorders.
• Preterm infants were more likely to receive outpatient antibiotics, bronchodilators, corticosteroids, diuretics, and thyroid hormones.

Conclusions:

• Despite advances in neonatal care, children born preterm require more healthcare resources and experience greater health challenges in their first five years.
• These findings underscore the critical need for continued support and monitoring of preterm infants beyond the neonatal period.
• Gestational age at birth is a significant predictor of long-term health service use and morbidity in childhood.