Slimings Claudia, Einarsdóttir Kristjana, Srinivasjois Ravisha, Leonard Helen
Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, Australia.
Paediatr Perinat Epidemiol. 2014 Nov;28(6):536-44. doi: 10.1111/ppe.12155. Epub 2014 Nov 4.
Infants born moderate to late preterm are twice as likely to be rehospitalised within the first few weeks following discharge from the birth admission. It is not understood how rehospitalisation risk changes with age or how risks have changed over time.
A retrospective birth cohort study of all live, singleton births in Western Australia 1 January 1980-31 December 2010, without congenital anomalies, followed to 18 years of age. Rehospitalisation rates for gestational age categories (<28, 28-31, 32-33, 34-36, 37-38 and ≥42 weeks) were compared with term births (39-41 weeks) using negative binomial regression. To assess whether rehospitalisation risk changed with age or over time, analyses were conducted for different age intervals and for 5-year birth cohorts.
Rehospitalisation rates were higher up to 18 years for all preterm and early term categories including early term (37-38 weeks) [130.2/1000 person-years at risk (pyr); 95% confidence interval 129.1, 131.4]; late preterm (34-36 weeks) (164.2/1000 pyr; 161.1, 167.4), and post-term (≥42 weeks) (115.3/1000 pyr; 111.7, 119.0) compared with term births (109.1/1000 pyr; 108.5, 109.7). The effect of gestational age on rehospitalisation was highest during the first year of life and declined by adolescence [e.g. 34-36 weeks: rate ratio = 2.10 (2.04, 2.15) for 29 days-1 year; 1.14 (1.11, 1.18) for 12-18 years]. The risk of rehospitalisation up to 1 year of age has declined since 1980, except for those born <32 weeks.
Rehospitalisation risk is greater for singleton children born at all gestational ages compared with those born full term. This effect of gestational age on rehospitalisation is highest in the first year post-discharge, but has almost disappeared by adolescence.
中度至晚期早产儿在出生入院出院后的头几周内再次住院的可能性是足月儿的两倍。目前尚不清楚再次住院风险如何随年龄变化，以及风险随时间发生了怎样的变化。
一项回顾性出生队列研究，研究对象为1980年1月1日至2010年12月31日在西澳大利亚州出生的所有存活单胎婴儿，无先天性异常，随访至18岁。使用负二项回归比较不同孕周类别（<28周、28 - 31周、32 - 33周、34 - 36周、37 - 38周和≥42周）与足月儿（39 - 41周）的再次住院率。为评估再次住院风险是否随年龄或时间变化，针对不同年龄区间和5年出生队列进行了分析。
所有早产和早期足月类别（包括早期足月（37 - 38周）[130.2/1000人年风险（pyr）；95%置信区间129.1, 131.4]；晚期早产（34 - 36周）（164.2/1000 pyr；161.1, 167.4）和过期产（≥42周）（115.3/1000 pyr；111.7, 119.0））在18岁前的再次住院率均高于足月儿（109.1/1000 pyr；108.5, 109.7）。孕周对再次住院的影响在生命的第一年最高，到青春期下降[例如，34 - 36周：29天至1岁时的率比 = 2.10（2.04, 2.15）；12 - 18岁时为1.14（1.11, 1.18）]。自1980年以来，1岁前再次住院的风险有所下降，但孕周<3早产儿除外。
与足月出生的儿童相比，所有孕周出生的单胎儿童再次住院的风险更高。孕周对再次住院的这种影响在出院后的第一年最高，但到青春期几乎消失。
