Type of Re-Hospitalization and Association with Neonatal Morbidities in Infants of Very Low Birth Weight

Abstract

Background: Preterm infants are at high risk for long-term morbidities and an increased rate of re-hospitalization. Objective: The aim of this study was to evaluate the type of re-hospitalization of very low birth weight (VLBW) infants, from infancy through adolescence, and to assess the association of neonatal morbidities with specific types of re-hospitalization. Study Design: The study cohort comprised 6,385 VLBW infants who were registered with the Maccabi Healthcare Services (MHS) from their birth hospitalization. Data were collected for up to 18 years (median 10.7 years) following neonatal intensive care unit discharge. Hospitalization types were determined from the MHS coding. Neonatal morbidities included necrotizing enterocolitis (NEC), grades 3–4 intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP). Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazards model. Results: Overall, 3,956 infants were re-hospitalized at least once and a total of 11,595 hospitalization types were identified. NEC, IVH, PVL, and BPD were associated with significantly higher aHRs for general pediatric (aHR 1.28–1.55), general surgical (aHR 1.18–1.46), and pediatric intensive care unit (aHR 1.57–2.04) hospitalizations. IVH and PVL were associated with significantly higher aHRs for orthopedic (aHR 2.12 and 4.88, respectively) and ophthalmology (1.76 and 4.02, respectively) hospitalizations. IVH was associated with a 14.2-fold higher aHR for neurosurgical admissions, and ROP with a 1.62-fold higher aHR for ophthalmology hospitalizations. Conclusion: Among VLBW infants, specific patterns of re-hospitalization types associated with major neonatal morbidities were identified as particularly high risks for orthopedic and ophthalmology hospitalizations in infants with IVH and PVL, and for intensive care admissions in infants with NEC and BPD.

Neonatal near miss and the occurrence of negative outcomes in the first year of life: data from a national survey, Nascer no Brasil (Born in Brazil), 2011-2012

“…Very low birth weight is also known to have an association with a higher frequency of rehospitalization and post neonatal mortality. 8,9 The necessity of a mechanical ventilation is a predictor on neonatal mortality. 10 However, it is realistic that the same occurs with neonatal near miss cases.…”

Clinical and diagnostic features in the study of the condition of the placentas of extremely premature newborns and disabling pathology at preschool age

“…The placental condition provides important information for elucidating factors that contributed to preterm birth, but placental features have not been reliably understood, and the relationship between placental changes and neonatal outcomes remains poorly studied [9][10][11]. Measures aimed at preventing premature birth and improving the life and health prognosis of premature babies in subsequent age periods are important; in particular, the implementation Medical Studies/Studia Medyczne 2022; 38/2 of modern methods of intensive care, respiratory support, and resuscitation care for newborns, including the use of modern breathing equipment, the use of non-invasive diagnostic measures, and modern drug therapy can save the lives of the youngest patients [12][13][14]. However, morbidity rates among preterm children remain high due to the occurrence of pathologies associated with morpho-functional immaturity [15,16].…”

“…The development of technologies for premature baby care has led to a significant decrease in the mortality rate of this newborn category. The introduction of modern methods of intensive care, respiratory support, and resuscitation of newborns, including the use of modern respiratory equipment, the use of noninvasive diagnostic measures, and modern drug therapy, can save the lives of the youngest patients [12][13][14]. At the same time, there is an increase in morbidity rates among premature infants due to pathologies associated with morpho-functional immaturity [15,16].…”

Long-term outcomes of bronchopulmonary dysplasia in preterm infants

“…Вищий ризик повторних госпіталізацій дітей з БЛД не обмежується раннім дитячим віком. У нещодавньому популяційному ізра їльському дослідженні діти з дуже малою масою при народженні, які перенесли БЛД, порівняно з такими самими дітьми без БЛД мали значно вищий ризик повторних госпіталі зацій, щонайменше протягом перших 10 років життя [25]. У популяційному дослідженні у штаті Вашингтон підлітки віком 12-20 років, які народились з малою або дуже малою масою тіла, мали вищий ризик повторних госпіталі зацій, пов'язаних з респіраторними симптома ми.…”