Rehospitalization for respiratory illness in infants of less than 32 weeks' gestation

C. K. Cunningham, J. A. McMillan, S. J. Gross

Research output: Contribution to journalArticlepeer-review

Abstract

All 133 surviving infants of gestational age ≤32 weeks born July 1, 1985, to June 30, 1986, as well as a socioeconomically matched full-term control group were observed prospectively for 2 years to determine the incidence of rehospitalization for respiratory illness. Perinatal and seasonal factors associated with increased risk for such hospitalizations were also examined. Forty-seven (36%) preterm infants were rehospitalized compared with 3(2.5%) of 121 term infants (P < .001). Preterm infants with and without rehospitalization were similar for mean birth weight (1104 ± 329 g and 1188 ± 360 g, respectively) and gestational age (28 ± 2 weeks for both groups); however, infants who were subsequently rehospitalized had required more days of mechanical ventilation, supplemental oxygen therapy, and neonatal intensive care. While a history of bronchopulmonary dysplasia was a risk factor for rehospitalization (45% compared with 25% of those without bronchopulmonary dysplasia, P < .05), preterm infants with no history of bronchopulmonary dysplasia still showed a 10-fold increase compared with control infants. Among the 43 infants who required no mechanical ventilation beyond the day of birth, 10 (23%) required rehospitalization. More than 80% of rehospitalized infants required their first admission within 4 months of discharge from the neonatal intensive care unit. Consequently, initial hospital discharge between September and December (the months immediately preceding peak respiratory viral season) resulted in an almost 3-fold increased risk of rehospitalization compared with discharge between May and August (P < .05). At 6 months of age, infants rehospitalized prior to that time had more than twice the incidence of neurologic abnormalities (12/23 [36%] vs 9/83 [11%], P < .01) than did infants who were never rehospitalized. The former group also had significantly lower motor scores on the Bayley Scales of Infant Development (89 ± 18 vs 97 ± 14, P < .05). These differences were not apparent at 15 and 24 months of age. Respiratory illness contributes significantly to postdischarge ty in preterm infants with and without chronic lung disease.

Original languageEnglish (US)
Pages (from-to)527-532
Number of pages6
JournalPediatrics
Volume88
Issue number3
StatePublished - Jan 1 1991
Externally publishedYes

Keywords

  • preterm infant
  • rehospitalization
  • respiratory illness

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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