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Do Premature Babies Have Higher Childhood Hospitalisation Rates than Full-term Babies?

Premature babies have a significantly higher risk of being hospitalised throughout childhood compared to full-term children, but the difference decreases over time, according to the findings of a new population-based cohort study published in the BMJ.

The study examined the association between gestational age at birth and hospital admissions to age 10 years in 1,018,136 live, singleton births in NHS hospitals in England between 2005 and 2006.

A total of 1,315,338 admissions occurred between 1 January 2005 and 31 March 2015, and 831,729 (63%) were emergency admissions. Just over half (n=525,039, 52%) of the total cohort were hospitalised at least once during the study period.

Hospital admissions were strongly associated with gestational age.

In comparison with children born at full term (40 weeks' gestation), those born extremely preterm (<28 weeks) had the highest rate of hospital admission throughout childhood (adjusted rate ratio [aRR], 4.92; 95% CI, 4.58-5.30).

Even children born at 38 weeks had a higher rate of hospital admission throughout childhood (aRR, 1.19; 95% CI, 1.16-1.22).

The association between gestational age and hospital admission decreased with increasing age (interaction P<.001).

Children born earlier than 28 weeks had an aRR of 6.34 (95% CI, 5.80-6.85) at age less than one year, declining to 3.28 (95% CI, 2.82-3.82) at ages 7-10 years, in comparison with those born full term; whereas, in children born at 38 weeks, the aRRs were 1.29 (95% CI, 1.27-1.31) and 1.16 (95% CI, 1.13-1.19) during infancy and ages 7-10 years, respectively.

Infection was the main cause of excess hospital admissions at all ages, but particularly during infancy. Respiratory and gastrointestinal conditions also accounted for a large proportion of admissions during the first two years of life.

Strategies aimed at the prevention and management of childhood infections should target children born preterm and those born a few weeks early, the authors concluded.

Coathup V, Boyle E, Carson C, Johnson S, Kurinzcuk JJ, Macfarlane A, Petrou S, Rivero-Arias O, Quigley MA. Gestational age and hospital admissions during childhood: population based, record linkage study in England (TIGAR study). BMJ. 2020;371:m4075. doi: 10.1136/bmj.m4075. PMID: 33239272. View full text

This article originally appeared on Univadis, part of the Medscape Professional Network.

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