Pediatric care for preterm infants after NICU discharge: high number of office visits and prescription medications

Wade, Kelly C.; Lorch, Scott A.; Bakewell-Sachs, Susan; Medoff‐Cooper, Barbara; Silber, Jeffrey H.; Escobar, Gabriel J.

doi:10.1038/jp.2008.74

Cited by 61 publications

(43 citation statements)

References 40 publications

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“…Of the 1192 subjects included in the historical cohort study of preterm infants, 27% developed BPD and 46% developed RDS; this is comparable with previously published data (12). Among all preterm infants, 25.6% suffered from patent ductus arteriosus, 10.4% from necrotizing enterocolitis and 11.6% from intraventricular hemorrhage.…”

Section: Discussionsupporting

confidence: 76%

Occurrence and severity of bronchopulmonary dysplasia and respiratory distress syndrome after a preterm birth

Landry

Menzies

2011

Paediatrics &Amp; Child Health

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D espite notable advances in prenatal and neonatal care, respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) remain important complications of preterm births, frequently resulting in mortality as well as short-term and long-term morbidity. BPD, as originally described by Northway et al (1), is less common today, but it has been replaced by a 'new' disease that typically follows mild to moderate RDS in small preterm infants who respond quickly to surfactant therapy but require prolonged ventilation for apnea and poor respiratory efforts (2). The accurate prediction of the development and severity of lung disease in preterm infants could assist clinicians in making critical decisions quickly (3) and could provide a better idea of the short-term prognosis to the treating team and family members. Identifying factors associated with preventing the onset of BPD is also an important facet of neonatology research.The present study of a large cohort of preterm infants had three objectives: to examine factors associated with the development of RDS and BPD, to examine factors associated with BPD severity and to develop a predictive equation for the occurrence of BPD following a preterm birth. Methods subjectsThe study population included all preterm infants (defined as a gestational age of younger than 37 weeks) who were admitted to the Montreal Children's Hospital (Montreal, Quebec) between January 1, 1980, and December 31, 1992. The Montreal Children's Hospital is a tertiary paediatric hospital with a specialized neonatal care department that serves as a referral centre for the province of Quebec. No infants are born at the Montreal Children's Hospital, and all study subjects were transferred to this institution following BACKGRoUNd: Despite notable advances in neonatal care, bronchopulmonary dysplasia (BPD) remains an important complication of preterm birth, frequently resulting in prolonged hospital stay and longterm morbidity. Methods: A historical cohort study of all preterm infants (gestational age younger than 37 weeks) admitted to the Montreal Children's Hospital (Montreal, Quebec) between January 1, 1980, and December 31, 1992, was conducted. Information collected included demographic data, maternal and perinatal history, and main neonatal outcomes. Independent risk factors associated with BPD were identified by univariate analysis using one-way ANOVA, t tests or Mantel-Haenszel c 2 testing. Severity of disease was studied using an ordinal multinomial logistic regression model. ResULts: In total, 1192 preterm infants were admitted, of whom 551 developed respiratory distress syndrome and 322 developed BPD. For each additional week of prematurity, the risk of developing BPD increased by 54% (adjusted OR 1.54/week [95% CI 1.45 to 1.64]). For each point subtracted on the 1 min Apgar score, the risk of developing BPD was increased by 16% (OR 1.16 [95% CI 1.1 to 1.3]). BPD was also associated with the presence of patent ductus arteriosus (OR 3.5 [95% CI 2.1 to 6.0]), pneumothorax in the first 48 h ...

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Section: Discussionsupporting

confidence: 76%

Occurrence and severity of bronchopulmonary dysplasia and respiratory distress syndrome after a preterm birth

Landry

Menzies

2011

Paediatrics &Amp; Child Health

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“…[15][16][17] Premature infants have increased ambulatory care needs, 12,18 but there are no data on the use of preventive care by NICU graduates when born to adolescent mothers. Therefore, this study was designed to investigate the effect of adolescent motherhood on preterm infant health care utilization during the first year after NICU discharge.…”

Section: What's Newmentioning

confidence: 99%

Premature Infants Born to Adolescent Mothers: Health Care Utilization After Initial Discharge

Ray¹,

Escobar²,

Lorch³

2010

Academic Pediatrics

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“…As a result, many NICU graduates have significantly more clinic visits than NBW infants [20]. Managing these appointments can be overwhelming for parents, particularly when they use a variety of different doctors and service organizations.…”

Section: ) Managing Infant Appointments Can Be Overwhelmingmentioning

confidence: 99%

“…At the same time, this first year is a critical time for growth and development for the infants. Yet, past work has shown that an infant's transition from the NICU to the home is poorly understood [20]. In our interviews, we asked parents to discuss their caregiving experiences, paying particular attention to their tracking of health and developmental data.…”

Section: A Challenges For Parents Capturing Infant Health Datamentioning

confidence: 99%

Balancing Caregiver and Clinician Needs in a Mobile Health Informatics Tool for Preterm Infants

Tang¹,

Hirano²,

Cheng³

et al. 2012

Proceedings of the 6th International Conference on Pervasive Computing Technologies for Healthcare

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Abstract-Preterm infants have significantly higher rates of functional limitations and are at risk for delays in cognitive, motor, and other skills. Through high-risk infant follow-up (HRIF) programs and other early detection methods, these delays and complications can be reduced. However, these interventions require substantial resources and can create extra burden on families. In this paper, we present the results of a qualitative design study to understand the needs of these families and their professional caregivers. These results reveal diverse challenges facing parents and clinicians attempting to document, understand, and share infant health data that must be balanced in any pervasive health solution. In particular, parents described struggling with when to collect data, while clinicians reported being more concerned about what and how parents track infant health. Based on these results, we present five design implications for applications for preterm infant care, which we incorporated into the design of Estrellita, a mobile health informatics tool to support caregivers of preterm infants.

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Pediatric care for preterm infants after NICU discharge: high number of office visits and prescription medications

Cited by 61 publications

References 40 publications

Occurrence and severity of bronchopulmonary dysplasia and respiratory distress syndrome after a preterm birth

Occurrence and severity of bronchopulmonary dysplasia and respiratory distress syndrome after a preterm birth

Premature Infants Born to Adolescent Mothers: Health Care Utilization After Initial Discharge

Balancing Caregiver and Clinician Needs in a Mobile Health Informatics Tool for Preterm Infants

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