Health service utilisation of a regional cohort of very preterm infants over the first 2 years of life.
OBJECTIVE
Very preterm infants represent major consumers of health services following neonatal discharge. We examined the health service utilisation of a regional cohort of very preterm infants over the first 2 years of life, including the association with neurodevelopmental outcome.


METHODS
A regionally based 2-year cohort of 100 very preterm infants along with a comparison sample of 104 full term control infants matched for sex, time and place of birth were recruited. Perinatal and social background factors that predispose very preterm infants to increased risk of subsequent general practitioner (GP) and hospital service use were identified. At 2 years, all children underwent a neurodevelopmental assessment, Bayley Scales of Infant Development (BSID-II). Details of children's medical contacts obtained by parent interview were cross-checked against GP and hospital records/databases.


RESULTS
Very preterm infants had a similar number of GP visits to term infants but more outpatient hospital visits. Fifty-three (55%) very preterm infants were admitted to hospital on 131 occasions compared with 26 (26%) term infants on 37 occasions (p<0.001). The main reason for hospitalisation in the preterm cohort was respiratory disorder. The frequency of hospital admissions was significantly related to birthweight (P=0.01), gestational age (P<0.001) and the number of people living in the family household (P=0.02). No associations were found between hospital admission and neurodevelopment at 2 years.


CONCLUSIONS
Very preterm infants had higher rates of hospital admissions and visits than term infants unrelated to neurodevelopmental outcome at 2 years of age. These findings highlight that very preterm birth is associated with ongoing health morbidity.
Gray
Diane
D
Neonatal Service, Christchurch Women's Hospital, and Canterbury Child Development Research Group, University of Canterbury, Christchurch, New Zealand.
Woodward
Lianne J
LJ
Spencer
Carole
C
Inder
Terrie E
TE
Austin
Nicola C
NC
D017677:Age Distribution; D016022:Case-Control Studies; D002662:Child Health Services / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005190:Family; D005260:Female; D005865:Gestational Age; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009520:New Zealand