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Older gestational age decreased risk of emergency respiratory hospital admission
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The risk of respiratory hospital admission up to age 5 years decreased for infants born at 40 to 42 weeks of gestation, according to recent study findings published in Pediatrics.
“Even at 39 weeks’ gestation, infants had a 10% increase in risk of emergency hospital admissions for respiratory conditions compared with those born at 40 to 42 weeks, and a further 7% increase in risk if they were small for gestational age,” the researchers wrote.
Shantini Paranjothy, PhD, of Cardiff University in the United Kingdom, and colleagues examined data on 318,613 children born between May 1, 1998, and Dec. 31, 2008, to determine whether the rate of emergency respiratory hospital admissions during childhood was associated with gestational age at birth and any growth restriction in utero.
Overall, 17.6% of participants had at least one emergency respiratory hospital admission. Participants born before 33 weeks’ gestation had a rate of admission during the first year of life of 41.5 per 100 child-years compared with 9.8 per 100 child-years for participants born at 40 to 42 weeks’ gestation. Acute upper respiratory tract infection (45.1%) was the most common reason for admission during the first year of life, followed by acute bronchiolitis (44.4%).
There was an increased risk of admission at 39 weeks’ gestation compared with 40 to 42 weeks’ gestation (adjusted HR=1.1; 95% CI, 1.08-1.13). An increased risk of admission also was associated with small for gestational age (adjusted HR=1.07; 95% CI, 1.04-1.1).
“We have demonstrated the utility of using large-scale record-linked data sets to describe the epidemiology of health care utilization in children, particularly focusing on gestation at birth,” the researchers wrote. “Our key finding is that the gradient of decreasing risk of respiratory emergency admissions with increasing gestational age extends to 40 weeks’ gestation. Although the magnitude of increased risk appears small, large numbers of infants are affected with significant implications for health services.”
Shantini Paranjothy, PhD, can be reached at ParanjothyS@cardiff.ac.uk.
Disclosure: Paranjothy reports no relevant financial disclosures.
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