Admissions and Emergency Visits by Late Preterm Singletons and Twins in the First 5 Years: A Population-Based Cohort Study

Abstract

Objective To compare admission and emergency visits of late preterm (34^0/7–36^6/7 weeks) versus term infants (37^0/7–41^6/7 weeks) in the first 5 years.

Study Design This population-based cohort study included all singletons and twins born alive at 34^0/7 to 41^6/7 weeks' gestation registered in a health administrative database in Ontario, Canada, between April 1, 2002 and December 31, 2012. Admissions and emergency visits from initial postnatal discharge to 5 years were compared between late preterm and term infants adjusting for maternal and infant characteristics.

Results A total of 1,316,931 infants (75,364 late preterm infants) were included. Late preterm infants had more frequent admissions than term infants in the first 5 years in both singletons (adjusted incidence rate ratio [95% confidence interval] = 1.46 [1.42–1.49]) and twins (1.21 [1.11–1.31]). The difference in admissions between late preterm and term infants were smaller in twins than singletons and decreased with children's ages. Twins had less frequent admissions than singletons for late preterm infants, but not for term infants. The emergency visits were more frequent in late preterm than term infants in all the periods.

Conclusion Admissions and emergency visits were more frequent in late preterm than term infants through the first 5 years. Admissions were less frequent in late preterm twins than singletons.

Keywords

newborn - late preterm infants - admissions - twins - cohort study

Authors' Contributions

T.I. conceptualized and designed the study, developed the study protocol, obtained the approval for data access, conducted the analyses, interpreted the study results, wrote the first draft manuscript, and revised the manuscript. T.I. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. D.O'R. and J.B. provided advice for designing the study, developing the study protocol, and conducting the analyses, interpreted the study results, and critically reviewed and revised the manuscript. P.S.S., S.K.L., and A.G. provided advice for developing the study protocol, and critically reviewed and revised the manuscript. S.D.M. supervised all aspects of this study, conceptualized and designed the study, developed the protocol, provided advice for conducting the analyses, interpreted the study results, and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Publication History

Received: 12 May 2019

Accepted: 13 November 2019

Article published online:
31 December 2019

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