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Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study

BACKGROUND: Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31 weeks of gestational age (GA). METHODS: This nation-wide population-based study used the French medico-administrative database to assess the following outcomes in singleton live-born infants (32...

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Autores principales: Iacobelli, Silvia, Combier, Evelyne, Roussot, Adrien, Cottenet, Jonathan, Gouyon, Jean-Bernard, Quantin, Catherine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5242044/
https://www.ncbi.nlm.nih.gov/pubmed/28100222
http://dx.doi.org/10.1186/s12887-017-0787-y
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author Iacobelli, Silvia
Combier, Evelyne
Roussot, Adrien
Cottenet, Jonathan
Gouyon, Jean-Bernard
Quantin, Catherine
author_facet Iacobelli, Silvia
Combier, Evelyne
Roussot, Adrien
Cottenet, Jonathan
Gouyon, Jean-Bernard
Quantin, Catherine
author_sort Iacobelli, Silvia
collection PubMed
description BACKGROUND: Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31 weeks of gestational age (GA). METHODS: This nation-wide population-based study used the French medico-administrative database to assess the following outcomes in singleton live-born infants (32–43 weeks) without congenital anomalies (year 2011): neonatal hospitalization (day of life 1 – 28), post-neonatal hospitalization (day of life 29 – 365), and 1-year in-hospital mortality rates. Marginal models and negative binomial regressions were used. RESULTS: The study included 696,698 live-born babies. The neonatal hospitalization rate was 9.8%. Up to 40 weeks, the lower the GA, the higher the hospitalization rate and the greater the likelihood of requiring the highest level of neonatal care (both p < 0.001). The relative risk adjusted for sex and pregnancy-related diseases (aRR) reached 21.1 (95% confidence interval [CI]: 19.2-23.3) at 32 weeks. The post-neonatal hospitalization rate was 12.1%. The raw rates for post-neonatal hospitalization fell significantly from 32 – 40 and increased at 43 weeks and this persisted after adjustment (aRR = 3.6 [95% CI: 3.3–3.9] at 32 and 1.5 [95% CI: 1.1–1.9] at 43 compared to 40 weeks). The main causes of post-neonatal hospitalization were bronchiolitis (17.2%), gastroenteritis (10.4%) ENT diseases (5.4%) and accidents (6.2%). The in-hospital mortality rate was 0.85‰, with a significant decrease (p < 0.001) according to GA at birth (aRR = 3.8 [95% CI: 2.4–5.8] at 32 and 6.6 [95% CI: 2.1–20.9] at 43, compared to 40 weeks. CONCLUSION: There’s a continuous change in outcome in hospitalized infants born above 31 weeks. Birth at 40 weeks gestation is associated with the lowest 1-year morbidity and mortality.
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spelling pubmed-52420442017-01-23 Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study Iacobelli, Silvia Combier, Evelyne Roussot, Adrien Cottenet, Jonathan Gouyon, Jean-Bernard Quantin, Catherine BMC Pediatr Research Article BACKGROUND: Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31 weeks of gestational age (GA). METHODS: This nation-wide population-based study used the French medico-administrative database to assess the following outcomes in singleton live-born infants (32–43 weeks) without congenital anomalies (year 2011): neonatal hospitalization (day of life 1 – 28), post-neonatal hospitalization (day of life 29 – 365), and 1-year in-hospital mortality rates. Marginal models and negative binomial regressions were used. RESULTS: The study included 696,698 live-born babies. The neonatal hospitalization rate was 9.8%. Up to 40 weeks, the lower the GA, the higher the hospitalization rate and the greater the likelihood of requiring the highest level of neonatal care (both p < 0.001). The relative risk adjusted for sex and pregnancy-related diseases (aRR) reached 21.1 (95% confidence interval [CI]: 19.2-23.3) at 32 weeks. The post-neonatal hospitalization rate was 12.1%. The raw rates for post-neonatal hospitalization fell significantly from 32 – 40 and increased at 43 weeks and this persisted after adjustment (aRR = 3.6 [95% CI: 3.3–3.9] at 32 and 1.5 [95% CI: 1.1–1.9] at 43 compared to 40 weeks). The main causes of post-neonatal hospitalization were bronchiolitis (17.2%), gastroenteritis (10.4%) ENT diseases (5.4%) and accidents (6.2%). The in-hospital mortality rate was 0.85‰, with a significant decrease (p < 0.001) according to GA at birth (aRR = 3.8 [95% CI: 2.4–5.8] at 32 and 6.6 [95% CI: 2.1–20.9] at 43, compared to 40 weeks. CONCLUSION: There’s a continuous change in outcome in hospitalized infants born above 31 weeks. Birth at 40 weeks gestation is associated with the lowest 1-year morbidity and mortality. BioMed Central 2017-01-18 /pmc/articles/PMC5242044/ /pubmed/28100222 http://dx.doi.org/10.1186/s12887-017-0787-y Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Iacobelli, Silvia
Combier, Evelyne
Roussot, Adrien
Cottenet, Jonathan
Gouyon, Jean-Bernard
Quantin, Catherine
Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study
title Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study
title_full Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study
title_fullStr Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study
title_full_unstemmed Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study
title_short Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study
title_sort gestational age and 1-year hospital admission or mortality: a nation-wide population-based study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5242044/
https://www.ncbi.nlm.nih.gov/pubmed/28100222
http://dx.doi.org/10.1186/s12887-017-0787-y
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