Murthy Prashanth, Soraisham Amuchou, Momin Sarfaraz, Abou Mehrem Ayman, Thomas Sumesh, Signal Nalini, Alshaikh Belal
Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada.
J Neonatal Perinatal Med. 2025 Jul;18(4):369-376. doi: 10.1177/19345798251339648. Epub 2025 May 5.
ObjectiveTo compare the length of hospitalization for moderate and late preterm infants (MLPIs; 32-36 weeks gestation) born at tertiary care (level III) perinatal centers versus secondary care perinatal centers (level II).MethodsThis was a retrospective cohort study of all MLPIs born at one of four perinatal centers (one tertiary and three secondary) in Calgary, Canada. All preterm infants born before 36 were routinely admitted to neonatal intensive care units (NICUs). We excluded infants with major congenital anomalies and those receiving planned palliative care. Multivariable logistic, propensity score-matched, and quantile regression analyses were used to adjust for potential confounding factors.ResultsOf the 1958 infants who met inclusion criteria, 676 (34.5%) infants were born at a tertiary care perinatal center with a level III NICU, and 1284 (65.5%) were born in secondary care perinatal centers with a level II NICU. The average gestational age was 34.8 weeks. Infants born at level II centers had shorter durations of hospital stay (adjusted mean difference [aMD] -1.0 day; 95% CI -1.7, -0.4) and tube feeding (aMD -2.2 day; 95% CI -2.9, -1.4), a lower need for peripheral intravenous access (adjusted odds ratio (aOR) 0.66; 95% CI 0.53, 0.83), reduced use of infant formula during hospitalization (aOR 0.58; 95% CI 0.43, 0.78), and a higher rate of breastmilk feeding at discharge (aOR 1.34; 95% CI 1.01, 1.77).ConclusionDelivery of MLPIs in secondary care perinatal centers is associated with shorter hospital stays and higher breastmilk feeding rates at discharge.
目的
比较在三级围产期中心（III级）与二级围产期中心（II级）出生的中度和晚期早产儿（MLPI；妊娠32 - 36周）的住院时间。
方法
这是一项对加拿大卡尔加里四个围产期中心（一个三级和三个二级）之一出生的所有MLPI进行的回顾性队列研究。所有36周前出生的早产儿均常规入住新生儿重症监护病房（NICU）。我们排除了患有重大先天性异常的婴儿以及接受计划性姑息治疗的婴儿。采用多变量逻辑回归、倾向评分匹配和分位数回归分析来调整潜在的混杂因素。
结果
在1958名符合纳入标准的婴儿中，676名（34.5%）在设有III级NICU的三级围产期中心出生，1284名（65.5%）在设有II级NICU的二级围产期中心出生。平均胎龄为34.8周。在II级中心出生的婴儿住院时间较短（调整后平均差[aMD] -1.0天；95%置信区间 -1.7，-0.4）和管饲时间较短（aMD -2.2天；95%置信区间 -2.9，-1.4），外周静脉通路需求较低（调整后比值比[aOR] 0.66；95%置信区间0.53，0.83），住院期间婴儿配方奶粉使用减少（aOR 0.58；95%置信区间0.43，0.78），出院时母乳喂养率较高（aOR 1.34；95%置信区间1.01，1.77）。
结论
在二级围产期中心分娩的MLPI与较短的住院时间和较高的出院时母乳喂养率相关。
