Short term outcomes in hospitalized infants

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Kristi Coe (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Robin Bartlett

Abstract: Infants admitted to the neonatal intensive care unit (NICU) are often those born between 32 and 38 weeks gestations. However, these older preterm and early term infants have not been well studied, possibly due to less risk of mortality than among infants born at earlier gestations. In the U.S., 10% of annual births are preterm and 26.5% are born early term at 37 and 38 weeks gestation (Martin, Hamilton, & Osterman, 2019). Of those born preterm, 71% were born late preterm between 34 to 36 weeks gestation and only 2.8% were born at less than 34 weeks gestation in the latest available U.S. data (Martin, Hamilton, Osterman, Driscoll, Drake, & Division of Vital Statistics, 2018). This observational cohort study using secondary data examined 159,529 infants born at 32 to 38 weeks gestation. The dataset used for this study was provided by Mednax© using their Clinical Data Warehouse from provider chart data for years 2015 through 2017. A total of 303 NICUs (level II and above) across the U.S. were represented in the dataset. Infants with major congenital anomalies were included in the study. This sample represented approximately 1.5% of annual U.S. births (Martin et al., 2018). The statistical methods for this study included basic analyses of sample characteristics with reporting of descriptive statistics. Additionally, statistical analyses focused on evaluation of infant development, health/illness and maternal relationships using the Transitions Theory (Chick & Meleis, 2010; Chick & Meleis, 1986; Meleis, 2010; Meleis, Sawyer, Im, Hilfinger, & Shumacher, 2000) as a framework for the study. The mean gestational age of infants in the dataset was 35.4 weeks and the largest group (19%) was infants born at 34 weeks gestation. Infants born at 32 weeks gestation totaled 8% of the sample and were the smallest group identified. Male infants comprised 56% of the sample, 87% were born in a hospital with a NICU, and 11% had major congenital anomalies. The mean length of stay was 13.1 days (SD +/- 13.3) and 91% of infants were singleton births. The mortality rate for this sample was only 1% (959 infants). Of the relationships examined, health/illness factors including chronic lung disease and major congenital anomalies had the largest effects on outcomes followed by situational or maternal factors including antenatal steroid administration and Black race. Gestational age and birthweight also had modest effects on outcomes but to a lesser degree than maternal factors. Major findings include that in this sample of infants born at 32 through 38 weeks gestation, those diagnosed with chronic lung disease and those born with major congenital anomalies were at highest risk for needing more days of respiratory support and greater lengths of stay, and had higher odds of negative outcomes including death and needing equipment at discharge such as oxygen or a monitor. Since the definition of chronic lung disease includes infants requiring oxygen at a month of life or at 36 weeks corrected age, these infants were likely the most preterm infants in the sample. Infants with major anomalies primarily included those with cardiac, neurological, and renal anomalies since only 10% of the sample included infants with trisomies. Keywords: Mid-preterm infants, late preterm infants, early term infants, older preterm infants

Additional Information

Language: English
Date: 2019
Early term infants, Late preterm infants, Mid-preterm infants, Older preterm and early term, Older preterm infants
Premature infants

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