title: Gestational age and hospital utilization: three-years follow-up of an area-based birth cohort.
abstract: OBJECTIVE
  To investigate differences by gestational age in emergency department visits and re-hospitalizations during the three years following childbirth discharge.
  
  
  METHODS
  We performed a historical cohort study in Lazio Region, Italy, for infants born in 2007-2008 to resident mothers. Health administrative data were used. Analysis was performed by multinomial logistic regression.
  
  
  RESULTS
  Of 90 545 infants, more than 50% had at least one emergency department visit, and 18.8% at least one re-hospitalization. After the exclusion of infants with congenital anomalies, relative risk ratios of re-hospitalization and, to a lesser extent, of emergency department visits increased by decreasing gestational age; the two events were also higher for mothers ≤35 years of age, with low education and of Italian nationality. Residency outside the metropolitan area was associated with an increased risk of re-hospitalization and a decreased risk of emergency department visits.
  
  
  CONCLUSIONS
  During the three years following childbirth discharge, re-hospitalizations and, to a lesser extent, emergency department use are inversely related to gestational age at birth; socio-demographic factors have an effect on the risk of infant use of hospital resources independent of gestational age.
authors.affiliation: Alessandra Lisi International Centre on Birth Defects and Prematurity, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Corchia
authors.affiliation: Dipartimento di Epidemiologia, Servizio Sanitario Regionale del Lazio, Rome, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Lapucci
authors.affiliation: Area Programmazione Rete Ospedaliera e Ricerca, Direzione Regionale Salute e Politiche Sociali, Regione Lazio, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Franco
authors.affiliation: Dipartimento di Epidemiologia, Servizio Sanitario Regionale del Lazio, Rome, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Farchi
authors.affiliation: Warwick Medical School, The University of Warwick, Coventry, United Kingdom.
authors.forename: Stavros
authors.initials: S
authors.lastname: Petrou
authors.affiliation: Area Programmazione Rete Ospedaliera e Ricerca, Direzione Regionale Salute e Politiche Sociali, Regione Lazio, Rome, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Di Lallo
mesh_terms: D015331:Cohort Studies; D004522:Educational Status; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D008297:Male; D008423:Maternal Age; D011247:Pregnancy; D012959:Socioeconomic Factors