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. 2017 Jan 18;17(1):28.
doi: 10.1186/s12887-017-0787-y.

Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study

Silvia Iacobelli  1   2 , Evelyne Combier  3 , Adrien Roussot  4 , Jonathan Cottenet  4 , Jean-Bernard Gouyon  1 , Catherine Quantin  5   6   7   8
Affiliations

Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study

Silvia Iacobelli et al. BMC Pediatr. .

Abstract

Background: Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31 weeks of gestational age (GA).

Methods: This nation-wide population-based study used the French medico-administrative database to assess the following outcomes in singleton live-born infants (32-43 weeks) without congenital anomalies (year 2011): neonatal hospitalization (day of life 1 - 28), post-neonatal hospitalization (day of life 29 - 365), and 1-year in-hospital mortality rates. Marginal models and negative binomial regressions were used.

Results: The study included 696,698 live-born babies. The neonatal hospitalization rate was 9.8%. Up to 40 weeks, the lower the GA, the higher the hospitalization rate and the greater the likelihood of requiring the highest level of neonatal care (both p < 0.001). The relative risk adjusted for sex and pregnancy-related diseases (aRR) reached 21.1 (95% confidence interval [CI]: 19.2-23.3) at 32 weeks. The post-neonatal hospitalization rate was 12.1%. The raw rates for post-neonatal hospitalization fell significantly from 32 - 40 and increased at 43 weeks and this persisted after adjustment (aRR = 3.6 [95% CI: 3.3-3.9] at 32 and 1.5 [95% CI: 1.1-1.9] at 43 compared to 40 weeks). The main causes of post-neonatal hospitalization were bronchiolitis (17.2%), gastroenteritis (10.4%) ENT diseases (5.4%) and accidents (6.2%). The in-hospital mortality rate was 0.85‰, with a significant decrease (p < 0.001) according to GA at birth (aRR = 3.8 [95% CI: 2.4-5.8] at 32 and 6.6 [95% CI: 2.1-20.9] at 43, compared to 40 weeks.

Conclusion: There's a continuous change in outcome in hospitalized infants born above 31 weeks. Birth at 40 weeks gestation is associated with the lowest 1-year morbidity and mortality.

Keywords: Early Term; Hospital discharge data; Late preterm; Moderate preterm; Morbidity; Mortality; PMSI.

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Figures

Fig. 1
Fig. 1
Cumulative days of hospitalization among 696 698 singleton live-born babies with GA ≥ 32 weeks of gestation (France, 2011)
See this image and copyright information in PMC

References

    1. Ananth CV, Friedman AM, Gyamfi-Bannerman C. Epidemiology of moderate preterm, late preterm and early term delivery. Clin Perinatol. 2013;40(4):601–610. doi: 10.1016/j.clp.2013.07.001. - DOI - PubMed
    1. Raju TN. Moderately preterm, late preterm and early term infants: research needs. Clin Perinatol. 2013;40(4):791–797. doi: 10.1016/j.clp.2013.07.010. - DOI - PMC - PubMed
    1. Harijan P, Boyle EM. Health outcomes in infancy and childhood of moderate and late preterm infants. Semin Fetal Neonatal Med. 2012;17(3):159–162. doi: 10.1016/j.siny.2012.02.002. - DOI - PubMed
    1. Vohr B. Long-term outcomes of moderately preterm, late preterm, and early term infants. Clin Perinatol. 2013;40(4):739–751. doi: 10.1016/j.clp.2013.07.006. - DOI - PubMed
    1. Gouyon JB, Iacobelli S, Ferdynus C, Bonsante F. Neonatal problems of late and moderate preterm infants. Semin Fetal Neonatal Med. 2012;17(3–4):146–152. doi: 10.1016/j.siny.2012.01.015. - DOI - PubMed

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