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. 2019 Dec 3;26(2):e96-e104.
doi: 10.1093/pch/pxz143. eCollection 2021 Apr-May.

Risk factors for re-hospitalization following neonatal discharge of extremely preterm infants in Canada

Zakariya Bambala Puthattayil  1 , Thuy Mai Luu  2 , Marc Beltempo  3 , Shannon Cross  4 , Thevanisha Pillay  5 , Marilyn Ballantyne  6 , Anne Synnes  7 , Prakesh Shah  8 , Thierry Daboval  1 ; Canadian Neonatal Follow-Up Network
Collaborators, Affiliations

Risk factors for re-hospitalization following neonatal discharge of extremely preterm infants in Canada

Zakariya Bambala Puthattayil et al. Paediatr Child Health. .

Abstract

Objective: Survivors of extremely preterm birth are at risk of re-hospitalization but risk factors in the Canadian population are unknown. Our objective is to identify neonatal, sociodemographic, and geographic characteristics that predict re-hospitalization in Canadian extremely preterm neonates.

Methods: This is a retrospective analysis of a prospective observational cohort study that included preterm infants born 22 to 28 weeks' gestational age from April 1, 2009 to September 30, 2011 and seen at 18 to 24 months corrected gestational age in a Canadian Neonatal Follow-Up Network clinic. Characteristics of infants re-hospitalized versus not re-hospitalized are compared. The potential neonatal, sociodemographic, and geographic factors with significant association in the univariate analysis are included in a multivariate model.

Results: From a total of 2,275 preterm infants born at 22 to 28 weeks gestation included, 838 (36.8%) were re-hospitalized at least once. There were significant disparities between Canadian provincial regions, ranging from 25.9% to 49.4%. In the multivariate logistic regression analysis, factors associated with an increased risk for re-hospitalization were region of residence, male sex, bronchopulmonary dysplasia, necrotizing enterocolitis, prolonged neonatal intensive care unit (NICU) stay, ethnicity, Indigenous ethnicity, and sibling(s) in the home.

Conclusion: Various neonatal, sociodemographic, and geographic factors predict re-hospitalization of extremely preterm infants born in Canada. The risk factors of re-hospitalization provide insights to help health care leaders explore potential preventative approaches to improve child health and reduce health care system costs.

Keywords: Extremely preterm; Infant; NICU; Neonatal follow-up; Re-hospitalization; Risk factors.

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Figures

Figure 1.
Figure 1.
Flow diagram of study population.
Figure 2.
Figure 2.
Re-hospitalization rates across Canada by provincial regions. BC British Columbia; CP (Canadian Prairies) Manitoba, Saskatoon, and Alberta; ON Ontario; QC Quebec; AP (Atlantic Provinces) Newfoundland and Labrador, Prince Edward Island, and Nova Scotia.
See this image and copyright information in PMC

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