Re-hospitalization in infants younger than 29 weeks' gestation in the EPIPAGE cohort.
OBJECTIVE
To estimate the re-hospitalization rate of extremely preterm children during infancy and associated factors after the recent improvement in survival rates.


METHODS
The cohort included all children born before 29 wk of gestation in nine French regions in 1997. All admissions between discharge from initial hospitalization and 9 mo after birth were considered. Factors studied included the child's characteristics at birth and during neonatal hospitalization, risk factors for infection after discharge and parents' socio-demographic characteristics. Adjusted odds ratios (aOR) for re-hospitalization for all reasons and for respiratory disorders were obtained from logistic regression models.


RESULTS
Of the 376 children, 178 were re-admitted at least once (47.3%; 95% CI: 42.3-52.4). Fifty-five percent of the hospitalized children were admitted at least once for respiratory disorders. The re-hospitalization rate was higher for children who had had chronic lung disease (aOR: 2.2; 95% CI: 1.3-3.7), those initially discharged between August and October (aOR: 2.5; 95% CI: 1.2-5.1) or between November and January (aOR: 3.2; 95% CI: 1.5-6.8), and children living with other children under six (aOR: 3.4; 95 %CI: 1.6-7.5). Re-hospitalizations were associated with neither gestational age nor the duration of neonatal hospitalization. Adjusted odds ratios for re-hospitalization for respiratory tract disorders were very similar to those for the overall hospitalizations.


CONCLUSIONS
Infants born before 29 wk have a very high risk of re-hospitalization. The associated factors can help define high-risk groups at discharge from the neonatal unit who need special surveillance.
Lamarche-Vadel
A
A
Research Unit on Perinatal Health and Women's Health, INSERM U149, Villejuif, France.
Blondel
B
B
Truffer
P
P
Burguet
A
A
Cambonie
G
G
Selton
D
D
Arnaud
C
C
Lardennois
C
C
du Mazaubrun
C
C
N'Guyen
S
S
Mathis
J
J
Bréart
G
G
Kaminski
M
M
D000328:Adult; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000628:therapy*; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012140:Respiratory Tract Diseases / Q000628:therapy; D012307:Risk Factors