Trends in planned early birth: a population-based study

Morris, Jonathan M.; Algert, Charles S.; Falster, Michael O.; Ford, Jane B.; Kinnear, Ann; Nicholl, Michael C.; Roberts, Christine L.

doi:10.1016/j.ajog.2012.06.082

Cited by 50 publications

(52 citation statements)

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“…Costs related to morbidity in infants born at 37 and 38 weeks gestation have not been investigated. 27 There has been a gradual increase in the rate of infants born late preterm and early term in a number developed countries [28][29][30] and this is partly due to planned births with an apparent lowering of the threshold for early intervention. 8 The clinical decision to perform a planned birth involves weighing up the risks of continuing the pregnancy for both the mother and/or baby against the risks of delivery before full term.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and Costs of Hospital Admissions in First Year of Life: A Population-Based Study

Lain

Nassar

Bowen

et al. 2013

The Journal of Pediatrics

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Objective: Identify health care utilization and associated costs of infants with and without severe neonatal morbidity in the first year of life.Methods: Data from the Perinatal Data Collection for all 601,455 live born infants born in NSW, Australia, 2001Australia, -2007 were linked to hospital admission data. Logistic regression models were used to investigate the association between severe neonatal morbidity and readmission to hospital once, and more than once in the first year; and average costs were calculated for infants with and without serious neonatal morbidity up to one year. Neonatal morbidity was assessed using a validated composite outcome indicator. Results:Four per cent of infants suffered neonatal morbidity, 14.6% were readmitted to hospital once and 4.6% were had multiple readmissions. Gestational age (GA) was the strongest predictor of infants readmitted to hospital once while severe neonatal morbidity was the strongest predictor of multiple admissions (aOR 2.49; 95% CI 2.36-2.62). Infants with severe neonatal morbidity cost, on average $30,238 in the first year compared to $3,307, the cost per year of infants without neonatal morbidity.The mean annual cost decreased on average 10% and 25% each increasing week of GA for infants with and without neonatal morbidity respectively. This cost decrease continued until 39 weeks where average costs plateaued. Conclusions:Infants born with severe neonatal morbidity have increased hospitalizations and costs in the first year of life; and hospitalizations increased with decreasing GA, even for infants born at 37-38 weeks.

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Section: Discussionmentioning

confidence: 99%

Risk Factors and Costs of Hospital Admissions in First Year of Life: A Population-Based Study

Lain

Nassar

Bowen

et al. 2013

The Journal of Pediatrics

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“…However, tThese risksare reduced as the gestational age extends towards term. 11 Recommendations for immediate delivery following preterm ruptured membranes close to term require grounding in good clinical evidence as even mild prematurity is associated with a significant health burden both in the short and long term. 12 We undertook an international multicentre randomized controlled trial to establish the optimal management of birth following preterm premature rupture of the membranes close to term (PPROMT): comparing immediate delivery with expectant management, the PPROMT Trial (ISRCTN44485060)…”

Section: Aimsmentioning

confidence: 99%

Immediate delivery compared with expectant management after preterm pre-labour rupture of the membranes close to term (PPROMT trial): a randomised controlled trial

et al. 2016

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A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.For more information, please contact eprints@nottingham.ac.uk 1 Immediate delivery compared with expectant management after preterm pre-labour rupture of the membranes close to term

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“…9 Infants born at 37 to 38 weeks' gestation have been shown to have an increased risk for readmission for jaundice previously 10 ; however, the impact of early discharge on these infants has not been investigated. An increasing amount of research about early term infants has shown these infants have more neonatal morbidity, 20 poorer long-term general health, 21 higher health service use and costs, 13 and poorer educational results 22 than infants born at 39 to 41 weeks' gestation.…”

Section: Figurementioning

confidence: 99%

Early Discharge of Infants and Risk of Readmission for Jaundice

et al. 2015

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OBJECTIVES: To examine the association between early discharge from hospital after birth and readmission to hospital for jaundice among term infants, and among infants discharged early, to investigate the perinatal risk factors for readmission for jaundice.METHODS: Birth data for 781 074 term live-born infants born in New South Wales, Australia from 2001 to 2010 were linked to hospital admission data. Logistic regression models were used to investigate the association between postnatal length of stay (LOS), gestational age (GA), and readmission for jaundice in the first 14 days of life. Other significant perinatal risk factors associated with readmission for jaundice were examined for infants discharged in the first 2 days after birth.RESULTS: Eight per 1000 term infants were readmitted for jaundice. Infants born at 37 weeks' GA with an LOS at birth of 0 to 2 days were over 9 times (adjusted odds ratio [aOR] 9.43; 95% CI, and at 38 weeks' GA were 4 times (aOR 4.05; 95% CI, 3.62-4.54) more likely to be readmitted for jaundice compared with infants born at 39 weeks' GA with an LOS of 3 to 4 days. Other significant risk factors for readmission for jaundice for infants discharged 0 to 2 days after birth included vaginal birth, born to mothers from an Asian country, born to first-time mothers, or being breastfed at discharge.CONCLUSIONS: This study can inform guidelines or policy about identifying infants at risk for readmission for jaundice and ensure that appropriate post-discharge follow-up is received.WHAT'S KNOWN ON THIS SUBJECT: Studies examining early postnatal discharge and readmission for jaundice report conflicting results. Infants born 37 to 38 weeks' gestation have an increased risk for readmission for jaundice; however, the impact of early discharge on this group has not been investigated. WHAT THIS STUDY ADDS:Early postnatal discharge was significantly associated with readmission for jaundice. Of the infants discharged early, those born 37 to 38 weeks' gestation, born via vaginal delivery, born to Asian mothers, or were breastfed had the greatest risk for readmission. Dr Lain participated in the study design, took primary responsibility of the data analysis, and drafted the initial manuscript; Associate Professor Roberts participated in the study design and data analysis and interpretation, and reviewed and revised manuscript; Dr Bowen participated in interpretation of the data and revision of manuscript for important clinical content; Associate Professor Nassar participated in the study design and data analysis and interpretation, and reviewed and revised manuscript; and all authors approved the final manuscript as submitted. The length of stay (LOS) in hospital after the birth of a child has been a controversial topic over the past few decades. A Cochrane Review found early postnatal discharge, defined as earlier than standard care, to have no adverse effects on breastfeeding and maternal depression when accompanied by a policy of nursing/midwifery home visits. However, they reported more re...

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Trends in planned early birth: a population-based study

Cited by 50 publications

References 54 publications

Risk Factors and Costs of Hospital Admissions in First Year of Life: A Population-Based Study

Risk Factors and Costs of Hospital Admissions in First Year of Life: A Population-Based Study

Immediate delivery compared with expectant management after preterm pre-labour rupture of the membranes close to term (PPROMT trial): a randomised controlled trial

Early Discharge of Infants and Risk of Readmission for Jaundice

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