Rates of rehospitalisation in the first 2 years among preterm infants discharged from the NICU of a tertiary children hospital in Vietnam: a follow-up study

Abstract

ObjectivesTo describe the characteristics of rehospitalisation in Vietnamese preterm infants and to examine the time-to-first-readmission between two gestational age (GA) groups (extremely/very preterm (EVP) vs moderate/late preterm (MLP)); and further to compare rehospitalisation rates according to GA and corrected age (CA), and to examine the association between potential risk factors and rehospitalisation rates.Design and settingA cohort study to follow up preterm infants discharged from a neonatal intensive care unit (NICU) of a tertiary children’s hospital in Vietnam.ParticipantsAll preterm newborns admitted to the NICU from July 2013 to September 2014.Main outcomesRates, durations and causes of hospital admission during the first 2 years.ResultsOf 294 preterm infants admitted to NICU (all outborn, GA ranged from 26 to 36 weeks), 255 were discharged alive, and 211 (83%) NICU graduates were followed up at least once during the first 2 years CA, of whom 56% were hospital readmitted. The median (IQR) of hospital stay was 7 (6–10) days. Respiratory diseases were the major cause (70%). Compared with MLP infants, EVP infants had a higher risk of first rehospitalisation within the first 6 months of age (p=0.01). However, the difference in risk declined thereafter and was similar from 20 months of age. There was an interaction in rehospitalisation rates between GA and CA. Longer duration of neonatal respiratory support and having older siblings were associated with higher rehospitalisation rates. Lower rates of rehospitalisation were seen in infants with higher cognitive and motor scores (not statistically significant in cognitive scores).ConclusionsHospital readmission of Vietnamese preterm infants discharged from NICU was frequent during their first 2 years, mainly due to respiratory diseases. Scale-up of follow-up programmes for preterm infants is needed in low-income and middle-income countries and attempts to prevent respiratory diseases should be considered.

“I abandoned my job to look after my baby.” Understanding the unpriced cost of care of a preterm infant: Caregivers’ lived experiences

“…Henceforth, it is not surprising the parents viewed cost of care of preterm infants as expensive since their input is often different. In a previous study, health providers found that the cost of care of infants with lower gestation age and birth weight was higher [14,18]. Physical and emotional drains which may affect performance that were observed in this study have also been reported elsewhere [19,20].…”

Infection prevention and control measures for preterm infants discharged into the community: a scoping review protocol

“…A 2020 Vietnamese cohort study found that of the 193 preterm infants studied from birth to 24-month corrected age, 47% were readmitted at least once in the first year and 22% in year 2. All causes across the 2 years were due to respiratory infections (70%) followed by other infectious diseases (15%), echoing findings of prior studies in high-income countries [ 19 ]. Recommendations included information provision for parents regarding illnesses and preventative practices to reduce readmission rates post-discharge [ 19 ].…”

“…All causes across the 2 years were due to respiratory infections (70%) followed by other infectious diseases (15%), echoing findings of prior studies in high-income countries [ 19 ]. Recommendations included information provision for parents regarding illnesses and preventative practices to reduce readmission rates post-discharge [ 19 ]. A 1-year, 2019, Austrian, observational study aimed to research the differences in infection number and severity between 72 preterm and 71 full-term infants [ 20 ].…”

Health service utilisation for acute respiratory infections in infants graduating from the neonatal intensive care unit: a population-based cohort study

“…The main strength of our study is in the availability and use of population-based datasets, with complete perinatal and demographic information to form the study cohort. This allowed us to document age-specific ARI incidence rates up to age 8 years, where other studies have only assessed frequency of re-hospitalisation following NICU discharge up to age 2 or 3 years [ 40 , 41 ]. The higher frequency reported in these studies, along with our findings here, suggests this is indicative of a true higher disease burden in NICU graduates, and not due to health seeking practices in our jurisdiction.…”