title: Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study.
abstract: Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31 weeks of gestational age (GA).
  
  
  
  This nation-wide population-based study used the French medico-administrative database to assess the following outcomes in singleton live-born infants (32-43 weeks) without congenital anomalies (year 2011): neonatal hospitalization (day of life 1 - 28), post-neonatal hospitalization (day of life 29 - 365), and 1-year in-hospital mortality rates. Marginal models and negative binomial regressions were used.
  
  
  
  The study included 696,698 live-born babies. The neonatal hospitalization rate was 9.8%. Up to 40 weeks, the lower the GA, the higher the hospitalization rate and the greater the likelihood of requiring the highest level of neonatal care (both p < 0.001). The relative risk adjusted for sex and pregnancy-related diseases (aRR) reached 21.1 (95% confidence interval [CI]: 19.2-23.3) at 32 weeks. The post-neonatal hospitalization rate was 12.1%. The raw rates for post-neonatal hospitalization fell significantly from 32 - 40 and increased at 43 weeks and this persisted after adjustment (aRR = 3.6 [95% CI: 3.3-3.9] at 32 and 1.5 [95% CI: 1.1-1.9] at 43 compared to 40 weeks). The main causes of post-neonatal hospitalization were bronchiolitis (17.2%), gastroenteritis (10.4%) ENT diseases (5.4%) and accidents (6.2%). The in-hospital mortality rate was 0.85‰, with a significant decrease (p < 0.001) according to GA at birth (aRR = 3.8 [95% CI: 2.4-5.8] at 32 and 6.6 [95% CI: 2.1-20.9] at 43, compared to 40 weeks.
  
  
  
  There's a continuous change in outcome in hospitalized infants born above 31 weeks. Birth at 40 weeks gestation is associated with the lowest 1-year morbidity and mortality.
authors.affiliation: Centre d'Etudes Périnatales de l'Océan Indien, CHU Sud Réunion, La Réunion, France.|Réanimation Néonatale et Pédiatrique, Néonatologie, CHU La Réunion, France.
authors.forename: Silvia
authors.initials: S
authors.lastname: Iacobelli
authors.affiliation: Centre d'Epidémiologie des Populations, Université de Bourgogne, EA4184, Dijon, France.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Combier
authors.affiliation: Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, F-21000, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Roussot
authors.affiliation: Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, F-21000, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cottenet
authors.affiliation: Centre d'Etudes Périnatales de l'Océan Indien, CHU Sud Réunion, La Réunion, France.
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Gouyon
authors.affiliation: Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, F-21000, France. catherine.quantin@chu-dijon.fr.|INSERM, CIC 1432, Dijon, France. catherine.quantin@chu-dijon.fr.|Clinical Investigation Center, Clinical epidemiology/Clinical trials unit, Dijon University Hospital, Dijon, France. catherine.quantin@chu-dijon.fr.|Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Villejuif, France. catherine.quantin@chu-dijon.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Quantin
mesh_terms: D005260:Female; D005602:France / Q000453:epidemiology; D005865:Gestational Age; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality*; D008297:Male; D012307:Risk Factors
keywords: Early Term; Hospital discharge data; Late preterm; Moderate preterm; Morbidity; Mortality; PMSI