Neonatal Med.  2018 Aug;25(3):96-101. 10.5385/nm.2018.25.3.96.

Hospital Visits from Respiratory Diseases of Early and Late Preterm Infants

Affiliations
  • 1Department of Pediatrics, Inha University Hospital, Inha University School of Medicine, Incheon, Korea. juyounglee@inha.ac.kr

Abstract

PURPOSE
We aimed to evaluate the respiratory illness-related hospital visits (out-patient clinics, emergency room, and re-admission) of preterm infants, and compare them according to corrected age and prematurity.
METHODS
We reviewed the medical records of preterm infants born at < 37 weeks of gestation admitted to the neonatal intensive care unit (NICU) at Inha University Hospital between January 2012 and June 2015. Infant follow-up appointments in both neonatology and pulmonology out-patient clinics occurred for at least 2 years after NICU discharge.
RESULTS
The proportion of infants who visited the hospital due to any respiratory illness was as high as 50% until 12 months of corrected age, and subsequently decreased over time. Hospital admission was significantly higher in early preterm infants ( < 34 weeks of gestation) compared to late preterm infants (≥34 and < 37 weeks of gestation). The proportion of infants who were re-admitted due to lower respiratory tract illness was significantly higher until 6 months of corrected age compared to the later, and did not differ between early and late preterm infants.
CONCLUSION
The proportion of hospital visits of preterm infants due to respiratory disease was high until 12 months of corrected age. Most notably, the re-admission proportion from lower respiratory tract illness was high under 6 months in both early and late preterm infants. Preterm infants within this age that are visiting the hospital with respiratory symptoms should be carefully observed and followed up.

Keyword

Preterm infants; Patient readmission; Respiratory tract diseases

MeSH Terms

Appointments and Schedules
Emergency Service, Hospital
Follow-Up Studies
Humans
Infant
Infant, Newborn
Infant, Premature*
Intensive Care, Neonatal
Medical Records
Neonatology
Outpatients
Patient Readmission
Pregnancy
Pulmonary Medicine
Respiratory System
Respiratory Tract Diseases

Figure

  • Figure 1. Study participants.*Excluded infants were cases with transfer-out, death, follow-up loss, or follow-up duration <2 years. Abbreviation: GA, gestational age.

  • Figure 2. Rate of hospital visits from respiratory diseases according to the corrected age of all preterm infants. (A) All hospital visits include visits on out-patient clinics, emergency rooms, and re-admission due to any respiratory illness:<6 months of age, 45.6%; 6 to 12 months of age, 46.4%; 12 to 18 months of age, 32.3%; 18 to 24 months of age, 28.6%; 24 to 36 months, 27.4%; >36 months of age, 12.0%. (B) Hospital visits include visits on out-patient clinics, emergency rooms, and re-admission due to lower respiratory tract (LRT) illness: <6 months of age, 24.2%; 6 to 12 months of age, 18.5%; 12 to 18 months of age, 14.1%; 18 to 24 months of age, 11.7%; 24 to 36 months, 10.5%; >6 months of age, 6.0%. (C) Readmission due to LRT illness: <6 months of age, 18.5%; 6 to 12 months of age, 14.5%; 12 to 18 months of age, 10.5%; 18 to 24 months of age, 5.7%; 24 to 36 months, 7.8%; >36 months of age, 2.7%.*P<0.05.

  • Figure 3. Comparison of early and late preterm infants on hospital visits from respiratory diseases according to the corrected age. (A) All hospital visits include visits on out-patient clinics, emergency rooms, and re-admission due to any respiratory illness: <6 months of age, 51.8% vs. 37.6%; 6 to 12 months of age, 52.5% vs. 38.5%; 12 to 18 months of age, 36.0% vs. 27.5%; 18 to 24 months of age, 33.1% vs. 22.9%; 24 to 36 months, 32.4% vs. 21.1%; >36 months of age, 10.1% vs. 7.3%. (B) Hospital visits include visits on out-patient clinics, emergency rooms, and re-admission due to lower respiratory tract (LRT) illness: <6 months of age, 27.3% vs. 20.2%; 6 to 12 months of age, 19.4% vs. 17.4%; 12 to 18 months of age, 13.7% vs. 14.7%; 18 to 24 months of age, 14.4% vs. 8.4%; 24 to 36 months, 13.0% vs. 7.5%; >36 months of age, 8.9% vs. 2.4%. (C) Readmission due to LRT illness: <6 months of age, 20.9% vs. 15.6%; 6 to 12 months of age, 15.1% vs. 13.8%; 12 to 18 months of age, 11.5% vs. 9.2%; 18 to 24 months of age, 7.9% vs. 2.8%; 24 to 36 months, 10.1% vs. 4.6%; >36 months of age, 2.9% vs. 1.2%. *P<0.05.


Reference

1. Korean Statistical Information Service. 2015 Population and Housing Census [Internet]. Daejeon: Korean Statistical Information Service;2015. [cited 2018 Aug 16]. Available from: http://kosis.kr/statisticsList/statisticsList_01List.jsp?vwcd=MT_ZTITLE & parented=A.
2. Underwood MA, Danielsen B, Gilbert WM. Cost, causes and rates of rehospitalization of preterm infants. J Perinatol. 2007; 27:614–9.
3. Shin JS, Kim YB, Lee YH, Shim GH, Chey MJ. Comparisons of clinical characteristics affecting readmission between late preterm infants and moderate preterm infants or full-term infants. Neonatal Med. 2016; 23:211–7.
4. Kotecha S. Lung growth for beginners. Paediatr Respir Rev. 2000; 1:308–13.
5. Colin AA, McEvoy C, Castile RG. Respiratory morbidity and lung function in preterm infants of 32 to 36 weeks' gestational age. Pediatrics. 2010; 126:115–28.
6. Vrijlandt EJ, Kerstjens JM, Duiverman EJ, Bos AF, Reijneveld SA. Moderately preterm children have more respiratory problems during their first 5 years of life than children born full term. Am J Respir Crit Care Med. 2013; 187:1234–40.
7. Slimings C, Einarsdóttir K, Srinivasjois R, Leonard H. Hospital admissions and gestational age at birth: 18 years of follow up in Western Australia. Paediatr Perinat Epidemiol. 2014; 28:536–44.
8. Lemons JA, Bauer CR, Oh W, Korones SB, Papile LA, Stoll BJ, et al. Very low birth weight outcomes of the National Institute of Child health and human development neonatal research network, January 1995 through December 1996.NICHD Neonatal Research Network. Pediatrics. 2001; 107:E1.
9. Holman RC, Shay DK, Curns AT, Lingappa JR, Anderson LJ. Risk factors for bronchiolitis-associated deaths among infants in the United States. Pediatr Infect Dis J. 2003; 22:483–90.
10. Martin JA, Kirmeyer S, Osterman M, Shepherd RA. Born a bit too early: recent trends in late preterm births. NCHS Data Brief. 2009; 24:1–8.
11. Na JY, Park N, Kim ES, Lee HJ, Shim GH, Lee JA, et al. Shortterm clinical outcomes of late preterm infants. Korean J Pediatr. 2009; 52:303–9.
12. Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, Barfield W, Weiss J, Evans S. Risk factors for neonatal morbidity and mortality among "healthy," late preterm newborns. Semin Perinatol. 2006; 30:54–60.
13. Bulut C, Gursoy T, Ovali F. Short-term outcomes and mortality of late preterm infants. Balkan Med J. 2016; 33:198–203.
14. Haroon A, Ali SR, Ahmed S, Maheen H. Short-term neonatal outcome in late preterm vs. term infants. J Coll Physicians Surg Pak. 2014; 24:34–8.
15. Warburton D, Schwarz M, Tefft D, Flores-Delgado G, Anderson KD, Cardoso WV. The molecular basis of lung morphogenesis. Mech Dev. 2000; 92:55–81.
16. Yoder BA, Gordon MC, Barth WH Jr. Late-preterm birth: does the changing obstetric paradigm alter the epidemiology of respiratory complications? Obstet Gynecol. 2008; 111:814–22.
17. Pike K, Jane Pillow J, Lucas JS. Long term respiratory consequences of intrauterine growth restriction. Semin Fetal Neonatal Med. 2012; 17:92–8.
18. Khashu M, Narayanan M, Bhargava S, Osiovich H. Perinatal outcomes associated with preterm birth at 33 to 36 weeks' gestation: a population-based cohort study. Pediatrics. 2009; 123:109–13.
19. Dietz PM, England LJ, Shapiro-Mendoza CK, Tong VT, Farr SL, Callaghan WM. Infant morbidity and mortality attributable to prenatal smoking in the U.S. Am J Prev Med. 2010; 39:45–52.
20. Speer CP. Neonatal respiratory distress syndrome: an inflammatory disease? Neonatology. 2011; 99:316–9.
21. Gunville CF, Sontag MK, Stratton KA, Ranade DJ, Abman SH, Mourani PM. Scope and impact of early and late preterm infants admitted to the PICU with respiratory illness. J Pediatr. 2010; 157:209–14.
22. Weiss ST, Ware JH. Overview of issues in the longitudinal analysis of respiratory data. Am J Respir Crit Care Med. 1996; 154(6 Pt 2):S208–11.
23. Gappa M, Stocks J, Merkus P. Lung growth and development after preterm birth: further evidence. Am J Respir Crit Care Med. 2003; 168:399.
24. Greenough A. Late respiratory outcomes after preterm birth. Early Hum Dev. 2007; 83:785–8.
25. Stocks J, Coates A, Bush A. Lung function in infants and young children with chronic lung disease of infancy: the next steps? Pediatr Pulmonol. 2007; 42:3–9.
26. Choi S, Kim S, Oh J, Lee N, Kim S, Kim M, et al. The respiratory morbidities in late-preterm infants compared with the earlypreterm and term infants throughout the first year of life. J Korean Soc Neonatol. 2012; 19:245–52.
Full Text Links
  • NM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr