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Am J Perinatol 2021; 38(08): 796-803
DOI: 10.1055/s-0039-3402718
Original Article

Admissions and Emergency Visits by Late Preterm Singletons and Twins in the First 5 Years: A Population-Based Cohort Study

Tetsuya Isayama
1   Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
2   Department of Newborn and Developmental Paediatrics, Sunnybrook Health Science Centre, Toronto, Ontario, Canada
3   Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
,
Daria O'Reilly
1   Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
4   Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
,
Joseph Beyene
1   Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
,
Shoo K. Lee
5   Department of Paediatrics, Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
6   Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
,
Prakesh S. Shah
5   Department of Paediatrics, Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
6   Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
,
Astrid Guttmann
6   Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
7   Institute for Clinical Evaluative Sciences, Sunnybrook Health Science Centre, Toronto, Ontario, Canada
,
Sarah D. McDonald
1   Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
8   Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
9   Department of Radiology, McMaster University, Hamilton, Ontario, Canada
› Author Affiliations Funding None.
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Abstract

Objective To compare admission and emergency visits of late preterm (340/7–366/7 weeks) versus term infants (370/7–416/7 weeks) in the first 5 years.

Study Design This population-based cohort study included all singletons and twins born alive at 340/7 to 416/7 weeks' gestation registered in a health administrative database in Ontario, Canada, between April 1, 2002 and December 31, 2012. Admissions and emergency visits from initial postnatal discharge to 5 years were compared between late preterm and term infants adjusting for maternal and infant characteristics.

Results A total of 1,316,931 infants (75,364 late preterm infants) were included. Late preterm infants had more frequent admissions than term infants in the first 5 years in both singletons (adjusted incidence rate ratio [95% confidence interval] = 1.46 [1.42–1.49]) and twins (1.21 [1.11–1.31]). The difference in admissions between late preterm and term infants were smaller in twins than singletons and decreased with children's ages. Twins had less frequent admissions than singletons for late preterm infants, but not for term infants. The emergency visits were more frequent in late preterm than term infants in all the periods.

Conclusion Admissions and emergency visits were more frequent in late preterm than term infants through the first 5 years. Admissions were less frequent in late preterm twins than singletons.

Keywords

newborn - late preterm infants - admissions - twins - cohort study

Authors' Contributions

T.I. conceptualized and designed the study, developed the study protocol, obtained the approval for data access, conducted the analyses, interpreted the study results, wrote the first draft manuscript, and revised the manuscript. T.I. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. D.O'R. and J.B. provided advice for designing the study, developing the study protocol, and conducting the analyses, interpreted the study results, and critically reviewed and revised the manuscript. P.S.S., S.K.L., and A.G. provided advice for developing the study protocol, and critically reviewed and revised the manuscript. S.D.M. supervised all aspects of this study, conceptualized and designed the study, developed the protocol, provided advice for conducting the analyses, interpreted the study results, and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.


Supplementary Material



Publication History

Received: 12 May 2019

Accepted: 13 November 2019

Article published online:
31 December 2019

© 2019. Thieme. All rights reserved.

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