Rehospitalization in Infants Born < 29 Weeks' Gestation during the First 2 Years of Life: Risk Assessment

Abstract

Objective This study aims to determine risk factors for rehospitalization in extremely premature infants.

Study Design A retrospective cohort study of 157 infants born < 29 weeks' gestational age assessing risk factors for rehospitalization through 2 years of life.

Results Multivariable logistic regression showed that an increasing number of respiratory infections (odds ratio [OR]: 1.8 [1.1–3.1] per infection p = 0.03) and inhaled steroid use at 1 year (OR: 4.0 [1.3–12.1] p = 0.01) were predictive of hospital readmission. Diuretic (OR: 27 [1.01–1,000] p = 0.04) and oxygen (OR: 32 [3.1–333] p = 0.004) use at 1 year were predictive of pediatric intensive care unit admission. The number of respiratory infections (OR: 2.8 [1.7–4.5] p < 0.0001) with reflux/aspiration necessitating G-tube/Nissen fundoplication surgical intervention with or without G-tubes alone (OR: 21.3 [2.9–166.7] p = 0.02 and OR: 22.7 [CI, 2.4–200] p = 0.04) was predictive of increased number of rehospitalizations.

Conclusions Key modifiable risk factors identified were reflux/aspiration and ongoing respiratory infections. Critical time periods for diuretic, oxygen, and inhaled steroid use in this population occurred at the age of 1 year.

Keywords

prematurity - rehospitalization - bronchopulmonary dysplasia - dysphagia - respiratory infection - pulmonary hypertension

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