Objective: This study evaluated the impact of specific neonatal morbidities on the risks for re-hospitalization up to 18 years after the birth hospitalization in children and adolescents born VLBW.
Patients and Methods: This observational study was performed on data of the Israel VLBW infant database linked together with Maccabi Healthcare Services (MHS) medical records. After NICU discharge, 6,385 VLBW infants born from 1995-2012 were registered with MHS from birth and form the study cohort. Multivariable negative binomial regression models were calculated to estimate the adjusted relative risk (aRR) and 95% confidence interval (CI) for re-hospitalization.
Results: Up to 18 years following discharge 3,956 infants were hospitalized at least once. The median duration of follow-up was 10.7 years with total follow-up of 67,454 patient years. The aRR`s (95%CI) for hospitalization were significantly increased for each of the morbidities: Surgical necrotizing enterocolitis (NEC) 2.71 (2.08-3.53), severe intraventricular hemorrhage (IVH) 2.13 (1.85-2.46), periventricular leukomalacia (PVL) 1.83 (1.58-2.13), bronchopulmonary dysplasia (BPD) 1.94 (1.72-2.17) and severe retinopathy of prematurity 1.59 (1.36-1.85). During the first 4 years children with surgically treated NEC, IVH, PVL, or BPD had approximately 1.5-2.5 fold higher risks for re-hospitalization compared to those without the specific morbidity. In the 11th-14th and 15th-18th years respectively, surgical NEC was associated with a 3.05 (1.32-7.04) and 3.26 (0.99-10.7) aRR and PVL was associated with a 2.67 (1.79-3.97) and 3.47 (2.03-5.92) aRR for re-hospitalization.
Conclusion: The excess risk of re-hospitalization through childhood and adolescence was significantly associated with specific neonatal morbidities and the number of morbidities.
