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Premature birth (before 37 weeks of gestation) is associated with a higher risk of hospitalization throughout childhood than a full birth (40 weeks gestation). This is the result of a study published today by the BMJ.
Although the risk decreased with increasing age of the children, especially after the age of 2, the risk persisted until the age of 10, even in children who were born in the 38th and 39th week of pregnancy and represent many children at risk, say the researchers.
Premature births are a major contributor to childhood illness. Existing evidence suggests that the risk of disease associated with premature births decreases with increasing age. However, it remains unclear at what age this begins to happen and how these changes change depending on the week of pregnancy at birth.
To investigate this further, a team of British researchers looked at the relationship between gestational age at birth and hospital admissions up to age 10 and how admission rates change over the course of childhood.
Their results are based on data from more than 1 million children born between January 1, 2005 and December 31, 2006 in NHS hospitals in England. Children were monitored from birth to March 31, 2015 (average 9.2 years per child) The researchers analyzed the number of hospitalizations.
Gestational age at birth was analyzed in weeks from less than 28 to 42 weeks.
Over 1.3 million hospital admissions were made during the study period, of which 831,729 (63%) were emergency rooms. Just over half (525,039) of the children were hospitalized at least once during the study period.
Taking into account other potentially influential risk factors such as mother’s age, marital status, and degree of social disadvantage, as well as the child’s gender, ethnicity, and month of birth, the researchers found that childhood hospital admissions are strongly related to gestational age at birth.
The infancy rate of hospital admission for babies born at 40 weeks of age was 28 per 100 person-years – this figure was about six times higher for babies born extremely prematurely (less than 28 weeks). By the time the children were 7-10 years old, the hospital admission rate for children born at 40 weeks of age was 7 per 100 person-years – this figure was about three times higher for children born less than 28 weeks old .
But children born a few weeks earlier also had higher admission rates. Birth at 37, 38 and 39 weeks of gestation was associated with a difference in the admission rate of 19, 9 and 3 admissions per 100 person-years in infancy compared to those born at 40 weeks of gestation.
The gestational age risk of hospitalization decreased over time, especially after age 2. However, an excessive risk persisted until the age of 10, even in children born between 38 and 39 weeks of gestation.
Although this excessive risk was relatively small at 38 and 39 weeks, the large number of babies born at this gestational age worldwide suggests that they are likely to have a large impact on hospital performance, the researchers say.
Infection was the leading cause of excessive hospital admissions in all age groups, especially in infancy. Respiratory diseases and gastrointestinal diseases also made up a large part of the recordings in the first two years of life.
This is an observational study so no cause can be established and the researchers point out some limitations, such as: B. the inability to consider various factors that can affect children’s health, such as: B. Maternal smoking and breastfeeding.
However, they say this was a large study, using routinely collected data over a 10-year period, and that the results remained relatively stable after further analysis, suggesting that the results stand up to scrutiny.
Hence, the researchers say their results indicate that gestational age at birth “is a strong predictor of childhood illness, with those born extremely prematurely at greatest risk of being hospitalized throughout childhood.”
Finding that infection was the leading cause of excessive hospitalization in all age groups led researchers to call for targeted strategies to prevent and better manage infections in children.
Future research should also look at gestational age as a continuum and examine it for results week after week, they conclude.
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Gestational Age and Childhood Hospital Admissions: Population Based, England Record Linkage Study (TIGAR Study), DOI: 10.1136 / bmj.m4075 Provided by the British Medical Journal
Quote: Premature Birth Associated with Higher Risk of Childhood Hospital Visits (2020, November 25) Retrieved November 25, 2020 from https://medicalxpress.com/news/2020-11-early-birth-linked-greater-hospital .html
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