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.
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http://dx.doi.org/10.1093/pch/pxz143 | DOI Listing |
Eur J Pediatr
January 2025
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Unlabelled: In very preterm-born infants, nutritional intake is important to reduce the risk of severe metabolic bone disease including the risk of a lower bone mineral density (BMD). The aim of this study was to evaluate bone mineral content (BMC) and BMD (measured as BMC per bone area (BA)) at six years of age in very preterm-born infants fed different diets post-discharge. Data on this topic so far is insufficient, and with this study we aim to supply more useful data.
View Article and Find Full Text PDFFront Med (Lausanne)
January 2025
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Objective: Pregnancies with large-for-gestational-age (LGA) fetuses are associated with increased risks of various adverse perinatal outcomes. While existing research primarily focuses on term neonates, less is known about preterm neonates. This study aims to explore the risks of adverse maternal and neonatal perinatal outcomes associated with LGA in term neonates and neonates with different degrees of prematurity, compared to appropriate-for-gestational-age (AGA) neonates.
View Article and Find Full Text PDFEur Radiol
January 2025
Departments of Radiology and Nuclear Medicine, Erasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands.
Chest imaging in children presents unique challenges due to varying requirements across age groups. For chest radiographs, achieving optimal images often involves careful positioning and immobilisation techniques. Antero-posterior projections are easier to obtain in younger children, while lateral decubitus radiographs are sometimes used when expiratory images are difficult to obtain and for free air exclusion.
View Article and Find Full Text PDFSoc Sci Med
January 2025
Department of Social and Cultural Anthropology, Autonomous University of Barcelona, Barcelona, Spain.
Neonatal expertise and technologies have been perfected over the last decades, improving preterm infants' survival rates and allowing a gradual reduction in the gestational age limits of fetal viability. Using the concept of viability as a starting point, we analyze decision-making processes regarding extremely preterm newborns at the limits of viability. Drawing on extensive ethnographic fieldwork in a public hospital in Barcelona between March and November 2023, we examine the knowledge forms, rationalities and values that healthcare workers employ when guiding families in decisions about infants' viability.
View Article and Find Full Text PDFPLoS One
January 2025
Clinic of Neonatology, Department of Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
It has been widely assessed that very preterm children (<32 weeks gestational age) present language and memory impairments compared with full-term children. However, differences in their underlying semantic memory structure have not been studied yet. Nevertheless, the way concepts are learned and organized across development relates to children's capacities in retrieving and using information later.
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