Khasawneh Wasim, Alyousef Rahaf, Akawi Zuhour, Al-Dhoon Areen, Odat Ahlam
Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Front Pediatr. 2021 Jun 16;9:685016. doi: 10.3389/fped.2021.685016. eCollection 2021.
Although late preterm infants (LPIs) account for the majority of preterm births, they are mistakenly labelled and treated as "near term." Whether longer initial hospital stay improves their outcomes and lowers readmission is controversial. The aim of this study is to identify maternal and perinatal factors associated with longer hospital stay and to assess the rate of readmission. The medical records of LPIs delivered at an academic center in Jordan over a 5-year period were reviewed. They were divided according to their initial hospital stay into: Early discharge group (ED, ≤ 3 days) and late discharge group (LD, > 3 days). Maternal and perinatal factors associated with > 3-day hospital stay were reported. The rate of readmission was compared between both groups. 2236 LPIs were included in the analysis representing 13% of total births and 81% of premature births. LD group constituted 54%. A thousand two hundred forty three (56%) required admission to NICU. Factors associated with longer hospital stay included maternal prolonged rupture of membranes (AOR 1.9, 95% C.I 1.5, 2.4, 0.000), C-section delivery (AOR 2.4, 95% C.I 1.9, 3, 0.001), <35-week gestation (AOR 3.8, 95% C.I 2.6, 5, 0.000), small-for-gestational age (AOR 1.9, 95% C.I 1.1, 3.8, 0.03), birthweight <2,500 g (AOR 1.3, 95% C.I 1.1, 1.6, 0.02), NICU admission (AOR 6.3, 95% C.I 3.4, 11.5, 0.000), RDS (AOR 2.3, 95% C.I 1.5, 3.6, 0.005), surfactant therapy (AOR 5, 95% C.I 1.9, 13.5, 0.001), use of CPAP (AOR 1.7, 95% C.I 1.2, 2.2, 0.001), jaundice (AOR 11.2, 95% C.I 7.7, 16.2, 0.000), and sepsis (AOR 10.3, 95% C.I 4.8, 22, 0.000). Readmission rate was 19% among the LD group and 13% among the ED group. LPIs are at high risk for developing prematurity-related morbidities and the duration of their initial hospital stay can be anticipated based on certain predisposing maternal and perinatal factors. Late discharge of LPIs does not lower the rate of readmission.
尽管晚期早产儿占早产总数的大多数，但他们却被错误地归类并当作“接近足月”的婴儿来对待。初始住院时间延长是否能改善他们的预后并降低再入院率，这一点存在争议。本研究的目的是确定与较长住院时间相关的母体和围产期因素，并评估再入院率。回顾了约旦一家学术中心在5年期间分娩的晚期早产儿的病历。根据他们的初始住院时间将其分为：早期出院组（ED，≤3天）和晚期出院组（LD，>3天）。报告了与住院时间>3天相关的母体和围产期因素。比较了两组的再入院率。2236例晚期早产儿纳入分析，占总出生数的13%，早产总数的81%。LD组占54%。1243例（56%）需要入住新生儿重症监护病房。与较长住院时间相关的因素包括母体胎膜早破时间延长（调整后比值比1.9，95%可信区间1.5，2.4；P=0.000）、剖宫产分娩（调整后比值比2.4，95%可信区间1.9，3；P=0.001）、孕周<35周（调整后比值比3.8,95%可信区间2.6，5；P=0.000）、小于胎龄儿（调整后比值比1.9，95%可信区间1.1,3.8；P=0.03）、出生体重<2500g（调整后比值比1.3，95%可信区间1.1,1.6；P=0.02）、入住新生儿重症监护病房（调整后比值比6.3，95%可信区间3.4,
