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29 November 2020 17:30:39
The risk of hospitalization associated with gestational age decreased over time, particularly after 2 years. However, an excess risk remained until the age of 10, even for babies born at 38 and 39 weeks of gestation. (Source: Pixabay)
Being born before 37 weeks of gestation is associated with a higher risk of hospitalization in infancy than full-term birth, says an observational study published Thursday in The BMJ.
Infections were the leading cause of excess hospital admissions at all ages, but particularly during childhood, the researchers said, adding that respiratory and gastrointestinal conditions also accounted for a large percentage of hospitalizations during the first two years of life. .
Researchers, including those from the University of Oxford in the UK, said their findings indicate that gestational age at birth “is a strong predictor of childhood disease, with extremely premature births being at increased risk of hospitalization. hospital in childhood “.
Although the risk declined as children grew, particularly after age 2, an excess risk remained until age 10, even for babies born at 38 and 39 weeks gestation, representing many potentially vulnerable children , they said.
Existing evidence suggests that the risk of disease associated with preterm birth decreases as babies grow, but it is unclear at what age this begins to occur and how these changes vary by gestational week of age at birth.
The researchers looked at the association between gestational age at birth and hospital admissions up to the age of 10 and how admission rates change during childhood.
Their findings are based on data from over 1 million children born in NHS hospitals in England between 1 January 2005 and 31 December 2006.
The children were monitored from birth through March 31, 2015 – an average of 9.2 years per child – during which time the researchers analyzed the number of hospital admissions.
Gestational age at birth was analyzed in weeks, ranging from less than 28 to 42 weeks. Over 1.3 million hospital admissions occurred during the study period, of which 831,729 (63%) were emergency admissions.
Just over half (525,039) of the children were hospitalized at least once during the study period.
After taking into account other potentially influential risk factors, such as the mother’s age, marital status and level of social deprivation, the child’s gender, ethnicity, and month of birth, the researchers found that hospitalizations in hospital during infancy were strongly associated with gestational age at birth.
The infancy hospitalization rate in infants born at 40 weeks was 28 per 100 person years – this figure was about six times higher in infants born extremely prematurely (less than 28 weeks), the researchers said.
When babies were 7 to 10 years of age, the hospital admission rate in babies born at 40 weeks was 7 per 100 person-years – this figure was about three times higher in those born at less than 28 weeks , they said.
However, according to the researchers, babies born a few weeks earlier also had higher admission rates.
Birth at 37, 38, and 39 weeks of gestation was associated with a difference in the admission rate of 19, 9, and 3 hospitalizations per 100 person years in infancy, respectively, compared to those born at 40 weeks.
The risk of hospitalization associated with gestational age decreased over time, particularly after 2 years. However, an excess risk remained until the age of 10, even for babies born at 38 and 39 weeks of gestation.
Although this excess risk at 38 and 39 weeks was relatively small, the large number of babies born globally at these gestational ages suggests they are likely to have a large impact on hospital services, the researchers said.
This is an observational study, so it is not possible to establish the cause, and the researchers point out some limitations, such as the inability to take into account several factors that can have an impact on the health of babies such as maternal smoking and breastfeeding.
However, they stated that this was a large study that used data collected routinely over a 10-year period and that the results remained relatively stable after further analysis, suggesting that the results hold up to control.
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