Re-hospitalization in infants younger than 29 weeks' gestation in the EPIPAGE cohort |
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Authors: | Lamarche-Vadel A,Blondel B,Truffer P,Burguet A,Cambonie G,Selton D,Arnaud C,Lardennois C,du Mazaubrun C,N'Guyen S,Mathis J,Bréart G,Kaminski M EPIPAGE Study Group |
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Affiliation: | Research Unit on Perinatal Health and Women's Health, INSERM U149, Villejuif, France. |
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Abstract: | AIM: To estimate the re-hospitalization rate of extremely preterm children during infancy and associated factors after the recent improvement in survival rates. METHOD: The cohort included all children born before 29 wk of gestation in nine French regions in 1997. All admissions between discharge from initial hospitalization and 9 mo after birth were considered. Factors studied included the child's characteristics at birth and during neonatal hospitalization, risk factors for infection after discharge and parents' socio-demographic characteristics. Adjusted odds ratios (aOR) for re-hospitalization for all reasons and for respiratory disorders were obtained from logistic regression models. RESULTS: Of the 376 children, 178 were re-admitted at least once (47.3%; 95% CI: 42.3-52.4). Fifty-five percent of the hospitalized children were admitted at least once for respiratory disorders. The re-hospitalization rate was higher for children who had had chronic lung disease (aOR: 2.2; 95% CI: 1.3-3.7), those initially discharged between August and October (aOR: 2.5; 95% CI: 1.2-5.1) or between November and January (aOR: 3.2; 95% CI: 1.5-6.8), and children living with other children under six (aOR: 3.4; 95 %CI: 1.6-7.5). Re-hospitalizations were associated with neither gestational age nor the duration of neonatal hospitalization. Adjusted odds ratios for re-hospitalization for respiratory tract disorders were very similar to those for the overall hospitalizations. CONCLUSION: Infants born before 29 wk have a very high risk of re-hospitalization. The associated factors can help define high-risk groups at discharge from the neonatal unit who need special surveillance. |
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Keywords: | Extremely preterm infant hospital re-admission risk factors |
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