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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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  • References

  • 1 United States Department of Health and Human Services (US DHHS). Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Division of Vital Statistics, Natality public-use data 2007–2014, on CDC WONDER Online Database, February 2016. Accessed December 27, 2016 at: http://wonder.cdc.gov/natality-current.html
    Google Scholar
  • 2 Teune MJ, Bakhuizen S, Gyamfi Bannerman C. et al. A systematic review of severe morbidity in infants born late preterm. Am J Obstet Gynecol 2011; 205 (04) 374.e1-374.e9
    CrossrefPubMedGoogle Scholar
  • 3 Moster D, Lie RT, Markestad T. Long-term medical and social consequences of preterm birth. N Engl J Med 2008; 359 (03) 262-273
    CrossrefPubMedGoogle Scholar
  • 4 Dotinga BM, Eshuis MS, Bocca-Tjeertes IF. et al. Longitudinal growth and neuropsychological functioning at age 7 in moderate and late preterms. Pediatrics 2016; 138 (04) e20153638
    CrossrefPubMedGoogle Scholar
  • 5 Boyle EM, Johnson S, Manktelow B. et al. Neonatal outcomes and delivery of care for infants born late preterm or moderately preterm: a prospective population-based study. Arch Dis Child Fetal Neonatal Ed 2015; 100 (06) F479-F485
    CrossrefPubMedGoogle Scholar
  • 6 Tomashek KM, Shapiro-Mendoza CK, Weiss J. et al. Early discharge among late preterm and term newborns and risk of neonatal morbidity. Semin Perinatol 2006; 30 (02) 61-68
    CrossrefPubMedGoogle Scholar
  • 7 Young PC, Korgenski K, Buchi KF. Early readmission of newborns in a large health care system. Pediatrics 2013; 131 (05) e1538-e1544
    CrossrefPubMedGoogle Scholar
  • 8 Kuzniewicz MW, Parker SJ, Schnake-Mahl A, Escobar GJ. Hospital readmissions and emergency department visits in moderate preterm, late preterm, and early term infants. Clin Perinatol 2013; 40 (04) 753-775
    CrossrefPubMedGoogle Scholar
  • 9 Refuerzo JS. Impact of multiple births on late and moderate prematurity. Semin Fetal Neonatal Med 2012; 17 (03) 143-145
    CrossrefPubMedGoogle Scholar
  • 10 Committee on Practice Bulletins—Obstetrics; Society for Maternal–Fetal Medicine. Practice Bulletin No. 169: multifetal gestations: twin, triplet, and higher-order multifetal pregnancies. Obstet Gynecol 2016; 128 (04) e131-e146
    CrossrefPubMedGoogle Scholar
  • 11 Kinra S, Davey Smith G, Jeffreys M, Gunnell D, Galobardes B, McCarron P. Association between sibship size and allergic diseases in the Glasgow Alumni Study. Thorax 2006; 61 (01) 48-53
    CrossrefPubMedGoogle Scholar
  • 12 Bodeau-Livinec F, Zeitlin J, Blondel B. et al; Etude Epidemiologique sur les Petits Ages Gestationnels (EPIPAGE) group. Do very preterm twins and singletons differ in their neurodevelopment at 5 years of age?. Arch Dis Child Fetal Neonatal Ed 2013; 98 (06) F480-F487
    CrossrefPubMedGoogle Scholar
  • 13 Statistics Canada. Births 2008 (Catalogue no. 84F0210X). Accessed April 9, 2017 at: http://www.statcan.gc.ca.myaccess.library.utoronto.ca/pub/84f0210x/84f0210x2008000-eng.pdf
    Google Scholar
  • 14 Institute for Clinical Evaluative Sciences (ICES). Data & Analytic Service (DAS). 2017 . Accessed January 6, 2017 at: http://www.ices.on.ca/DAS
    Google Scholar
  • 15 Provincial Council for Maternal and Child Health. Standardized Maternal and Newborn Levels of Care Definitions. Updated August 2013. Accessed January 25, 2017 at: http://www.pcmch.on.ca/wp-content/uploads/2015/07/Level-of-Care-Guidelines-2011-Updated-August1-20131.pdf
    Google Scholar
  • 16 Juurlink D, Preyra C, Croxford R. et al. Canadian Institute for Health Information Discharge Abstract Database: A Validation Study. Toronto: Institute for Clinical Evaluative Sciences; 2006 . Accessed February 5, 2017 at: http://www.ices.on.ca/Publications/Atlases-and-Reports/2006/Canadian-Institute-for-Health-Information
    Google Scholar
  • 17 Canadian Institute for Health Information. CIHI Data Quality Study of the 2009–2010. Discharge Abstract Database. (Ottawa, Ont.: CIHI, revised 2012). Accessed February 21, 2017 at: https://secure.cihi.ca/free_products/Reabstraction_june19revised_09_10_en.pdf
    Google Scholar
  • 18 Canadian Institute for Health Information. Database Background and General Data Limitations Documentation, National Ambulatory Care Reporting System (NACRS), 2007–2008—Executive Summary (Ottawa, Ont.: CIHI, 2008). Accessed February 23, 2017 at: https://www.cihi.ca/en/nacrs_exec_summ_2007-2008_en.pdf
    Google Scholar
  • 19 Ray JG, Urquia ML, Berger H, Vermeulen MJ. Maternal and neonatal separation and mortality associated with concurrent admissions to intensive care units. CMAJ 2012; 184 (18) E956-E962
    CrossrefPubMedGoogle Scholar
  • 20 Cohen E, Berry JG, Camacho X, Anderson G, Wodchis W, Guttmann A. Patterns and costs of health care use of children with medical complexity. Pediatrics 2012; 130 (06) e1463-e1470
    CrossrefPubMedGoogle Scholar
  • 21 Vigod SN, Gomes T, Wilton AS, Taylor VH, Ray JG. Antipsychotic drug use in pregnancy: high dimensional, propensity matched, population based cohort study. BMJ 2015; 350: h2298
    CrossrefPubMedGoogle Scholar
  • 22 Urquia ML, Frank JW, Moineddin R, Glazier RH. Immigrants' duration of residence and adverse birth outcomes: a population-based study. BJOG 2010; 117 (05) 591-601
    CrossrefPubMedGoogle Scholar
  • 23 Better Outcomes Registry & Network (BORN) Ontario Annual Report 2012–2013 and 2013–2014. Ottawa, Ontario, 2015. Accessed April 23, 2016 at: https://www.bornontario.ca/en/about-born/governance/annual-reports/
    Google Scholar
  • 24 Wilkins R. Use of postal codes and addresses in the analysis of health data. Health Rep 1993; 5 (02) 157-177
    PubMedGoogle Scholar
  • 25 Provincial Council for Maternal and Child Health. Ontario Maternal and Newborn Level of Care Designations. 2017 . Accessed January 18, 2017 at: http://www.pcmch.on.ca/wp-content/uploads/2015/09/LOC_Designations_-2014SEP08.pdf
    Google Scholar
  • 26 Holm S. A simple sequentially rejective multiple test procedure. Scand J Stat 1979; 6 (02) 65-70
    PubMedGoogle Scholar
  • 27 Patrick SW, Burke JF, Biel TJ, Auger KA, Goyal NK, Cooper WO. Risk of hospital readmission among infants with neonatal abstinence syndrome. Hosp Pediatr 2015; 5 (10) 513-519
    CrossrefPubMedGoogle Scholar
  • 28 Oddie SJ, Hammal D, Richmond S, Parker L. Early discharge and readmission to hospital in the first month of life in the Northern Region of the UK during 1998: a case cohort study. Arch Dis Child 2005; 90 (02) 119-124
    CrossrefPubMedGoogle Scholar
  • 29 Pittard III WB. Well-child care in infancy and healthcare services utilization from birth to 6 years by late preterm children receiving Medicaid benefits. South Med J 2013; 106 (02) 173-179
    CrossrefPubMedGoogle Scholar
  • 30 Boyle EM, Poulsen G, Field DJ. et al. Effects of gestational age at birth on health outcomes at 3 and 5 years of age: population based cohort study. BMJ 2012; 344: e896
    CrossrefPubMedGoogle Scholar
  • 31 Slimings C, Einarsdóttir K, Srinivasjois R, Leonard H. Hospital admissions and gestational age at birth: 18 years of follow up in Western Australia. Paediatr Perinat Epidemiol 2014; 28 (06) 536-544
    CrossrefPubMedGoogle Scholar
  • 32 Papiernik E, Zeitlin J, Delmas D. et al; MOSAIC Group. Differences in outcome between twins and singletons born very preterm: results from a population-based European cohort. Hum Reprod 2010; 25 (04) 1035-1043
    CrossrefPubMedGoogle Scholar
  • 33 Whyte R. Safe discharge of the late preterm infant. Paediatr Child Health 2010; 15 (10) 655-666
    CrossrefPubMedGoogle Scholar
  • 34 Iron K, Zagorski B, Sykora K, Manuel D. Living and Dying in Ontario: An Opportunity for Improved Health Information. ICES Investigative Report. Toronto: Institute for Clinical Evaluative Sciences; 2008
    Google Scholar
  • 35 Meara E, Kotagal UR, Atherton HD, Lieu TA. Impact of early newborn discharge legislation and early follow-up visits on infant outcomes in a state Medicaid population. Pediatrics 2004; 113 (06) 1619-1627
    CrossrefPubMedGoogle Scholar
  • 36 Yonemoto N, Dowswell T, Nagai S, Mori R. Schedules for home visits in the early postpartum period. Cochrane Database Syst Rev 2013; (07) CD009326
    PubMedGoogle Scholar
  • 37 Conners GP, Melzer SM, Betts JM. et al; Committee on Hospital Care; Committee on Pediatric Emergency Medicine. Pediatric observation units. Pediatrics 2012; 130 (01) 172-179
    CrossrefPubMedGoogle Scholar