November 29, 2020 5:30:39 PM
The risk of hospitalization related to gestational age decreased over time, especially after 2 years of age. However, an increased risk persisted up to the age of 10 years, even for children born at 38 and 39 weeks gestation. (Source: Pixabay)
Being born before a 37-week gestation is associated with a greater risk of hospitalization in childhood than being born full-term, says an observational study published Thursday in The BMJ.
Infections were the leading cause of over-hospital admissions at all ages, but especially during childhood, the researchers said, with the addition of respiratory and gastrointestinal conditions also responsible for much of the admissions during the first two years of life.
The researchers, including those from the University of Oxford, UK, said their findings indicate that gestational age at birth “is a strong predictor of childhood illness, with extremely premature births most at risk of hospitalization in childhood.”
Although the risk decreased as the children grew up, especially after the age of 2 years, an increased risk persisted until the age of 10, even for children born at 38 and 39 weeks of gestation, representing many potentially vulnerable children. they said.
Existing evidence suggests that the risk of disease associated with preterm birth decreases with age, but it remains unclear at what age this begins to occur and how these changes vary by week of gestational age at birth.
The researchers examined the relationship between gestational age at birth and hospital admissions up to age 10 and how admission rates change during childhood.
Their findings are based on data from more than 1 million children born in NHS hospitals in England between January 1, 2005 and December 31, 2006.
Children were followed from birth to March 31, 2015 – an average of 9.2 years per child – during which time the researchers analyzed the number of hospital admissions.
The gestational age at birth was analyzed in weeks ranging from less than 28 to 42 weeks. More than 1.3 million hospital admissions took place during the study period, including 831,729 (63 percent) emergency admissions.
Slightly more than half (525,039) of the children were hospitalized at least once during the study period.
After taking into account other potentially influential risk factors, such as maternal age, marital status, and degree of social deprivation, and the child’s gender, ethnicity, and month of birth, the researchers found that hospital admissions during childhood were highly were related to gestational age at birth.
The childhood hospital admission rate in babies born at 40 weeks was 28 per 100 person-years – this figure was about six times higher in babies born extremely prematurely (less than 28 weeks), the researchers said.
By the time the children were 7-10 years old, the hospital admission rate in children born at 40 weeks was 7 per 100 person-years – this figure was about three times higher in those born at less than 28 weeks, they said.
But even children born a few weeks prematurely had higher admission rates, according to the researchers.
Births at 37, 38 and 39 weeks of pregnancy were associated with a difference in the number of admissions of 19, 9 and 3 admissions per 100 person years during childhood, respectively, compared to those born at 40 weeks.
The risk of hospitalization related to gestational age decreased over time, especially after 2 years of age. However, an increased risk persisted up to the age of 10 years, even for children born at 38 and 39 weeks gestation.
While this additional risk was relatively small at 38 and 39 weeks, the high number of babies born worldwide at this gestational age suggests that they are likely to have a major impact on hospital services, the researchers said.
This is an observational study, so the cause cannot be determined, and the researchers point out some limitations, such as not being able to account for various factors that can affect children’s health, such as maternal smoking and breastfeeding.
However, they said this was a large study with data routinely collected over a 10-year period, and the findings remained relatively stable after further analysis, suggesting that the results endure criticism.
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