title: The influence of early-term birth on NICU admission, length of stay, and breastfeeding initiation and duration.
abstract: OBJECTIVE
  To examine hospitalization and breastfeeding (BF) experiences for early-term (ET) and full-term (FT) infants to determine if differences existed between them.
  
  
  METHODS
  Retrospective descriptive cohort study.
  
  
  METHODS
  United States 2009.
  
  
  METHODS
  Stratified systematic sample of ET (n = 4052) and FT (n = 6825) infants.
  
  
  METHODS
  Infants whose mothers completed the Pregnancy Risk Assessment Monitoring System (PRAMS) survey were eligible for inclusion. Extreme discordant phenotype design was used to establish infant groups (ET = 37 weeks/260-267 days; FT = 40-41 weeks/282-294 days). Secondary data analysis was used to examine neonatal intensive care unit (NICU) admission, length of stay (LOS), BF initiation and duration, maternal reasons for BF noninitiation, and predictors of BF start and continuance.
  
  
  RESULTS
  Early-term infants had higher incidences of NICU admission (OR = 1.56), LOS 3-14 days (OR = 1.16), and BF noninitiation (OR = 1.5) when compared (weighted analysis) to FT infants. Early-term gestation was a predictor of BF noninitiation (OR = 1.42) and duration of BF fewer than 4 weeks (OR = 1.309) in nonweighted models. Other predictors of BF noninitiation included African American race, White versus other non-African American race, less maternal education, marital status other, maternal smoking, and maternal medical risk factors. Predictors of shortened BF duration for the sample included African American race versus White race, White versus other non-African American race, less maternal education, marital status other, maternal age younger than age 20 years, and maternal smoking.
  
  
  CONCLUSIONS
  Differences in care experienced by ET versus FT infants were identified. Maternal report of ET infant NICU admission and LOS was consistent with studies based on medical records data while new knowledge about ET infant BF patterns emerged.
authors: Debra V
authors: DV
authors: Craighead
authors: R K
authors: RK
authors: Elswick
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data*; D008425:Maternal Behavior / Q000502:physiology / Q000523:psychology; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D012189:Retrospective Studies; D018570:Risk Assessment; D012959:Socioeconomic Factors; D047929:Term Birth; D014481:United States / Q000453:epidemiology
keywords: Early-term infant; NICU admission; PRAMS; breastfeeding; length of stay