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Postconceptional age of surviving preterm low-birth-weight infants at hospital discharge
1Department of Pediatrics, Madigan Army Medical Center, Tacoma, Wash, USA.
Insights
Postconceptional age is a reliable clinical marker for predicting hospital stay duration in preterm, low-birth-weight infants. This simplifies discharge planning, especially for very low birth weight infants requiring longer stays.
Area of Science:
- Neonatal Medicine
- Pediatric Healthcare
- Clinical Outcomes Research
Background:
- Current methods for predicting hospital stay duration for preterm, low-birth-weight infants rely on inconvenient published tables.
- A more accessible clinical marker is needed for convenient prediction of individual hospital stay durations.
Purpose of the Study:
- To evaluate postconceptional age (gestational age plus chronologic age) as a clinical marker for predicting hospital stay duration in preterm, low-birth-weight infants.
- To determine if postconceptional age offers a more convenient alternative to existing prediction methods.
Main Methods:
- A case series study was conducted with 960 surviving preterm, low-birth-weight infants in a neonatal intensive care unit.
- Analysis of variance was used to assess the relationship between birth weight and postconceptional age at discharge.
Main Results:
- Postconceptional age at hospital discharge showed a highly predictable correlation with birth weight (P<.001).
- Infants with very low birth weights exhibited the greatest mean and variance in postconceptional age at discharge.
- A minimum postconceptional age of 36.0 ± 1.4 weeks was observed at discharge for infants weighing 1750 to 2240 g.
Conclusions:
- Most preterm, low-birth-weight infants are eligible for discharge between 35 to 37 weeks postconceptional age.
- Postconceptional age serves as a convenient and predictive clinical marker for expected hospital stay durations.
- For infants under 1000 g, a discharge postconceptional age of 37 to 42 weeks is a more realistic expectation.
Background:
Prediction of the duration of hospital stay of preterm, low-birth-weight infants currently requires inconvenient referral to published tables.
Objective:
To determine whether postconceptional age (gestational age plus chronologic age) could serve as a useful clinical marker for the more convenient prediction of individual durations of hospital stay.
Design:
Case series.
Setting:
Regional military teaching medical center with level III obstetric and neonatal services.
Patients:
Nine hundred sixty surviving preterm, low-birth-weight infants in the neonatal intensive care unit.
Main Outcome Measure:
The strength of the relationship of birth weight to postconceptional age at the time of discharge was tested by analysis of variance.
Results:
Postconceptional age at the time of hospital discharge varied in a highly predictable manner with birth weight (P<.001). The mean and variance were greatest for infants with very low birth weights and decreased with increasing birth weight. Postconceptional age at the time of discharge reached a minimum of 36.0 +/- 1.4 weeks (mean +/- SD) for infants with birth weights of 1750 to 2240 g.
Conclusions:
Most preterm, low-birth-weight infants meet current eligibility criteria for hospital discharge at a postconceptional age of 35 to 37 weeks. This level of maturity is sufficiently predictive to serve as a convenient, easy-to-remember clinical marker for expected durations of hospital stay. For infants with birth weights of less than 1000 g, discharge at a post-conceptional age of 37 to 42 weeks is a more realistic expectation.
