Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery
Abstract
:1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Extreme PTB (n = 118) (%) | Very PTB (n = 776) (%) | Moderate-Late PTB (n = 13,308) (%) | Term Birth (n = 206,361) (%) | p-Value |
---|---|---|---|---|---|
Maternal Age, years (mean ± SD) | 28.47 ± 6.34 | 28.36 ± 6.37 | 28.31 ± 6.24 | 28.24 ± 5.76 | 0.482 |
Gravidity | |||||
1 | 29.7 | 24.5 | 23.3 | 20.2 | <0.001 |
2–4 | 46.6 | 44.8 | 44.5 | 48.7 | |
5+ | 23.7 | 30.7 | 32.1 | 31.2 | |
Parity | |||||
1 | 38.1 | 31.4 | 29.0 | 24.2 | |
2–4 | 48.3 | 47.7 | 47.7 | 52.0 | <0.001 |
5+ | 13.6 | 20.9 | 23.3 | 23.8 | |
Smokers | 4.2 | 1 | 1.5 | 1 | <0.001 |
Fertility treatments | <0.001 | ||||
In vitro fertilization | 3.4 | 2.6 | 2.3 | 1.1 | |
Ovulation induction | 1.7 | 1.8 | 1.1 | 0.8 | |
Hypertensive disorders * | 8.5 | 19.1 | 12.9 | 4.7 | <0.001 |
Maternal diabetes ** | 0.0 | 6.2 | 8.1 | 5.2 | <0.001 |
Induction of labor | 14.3 | 4 | 27.3 | 31.8 | <0.001 |
Type of birth | <0.001 | ||||
Vaginal delivery | 48.3 | 46.5 | 67.3 | 83.9 | |
Assisted vaginal delivery | 0 | 0.6 | 1.7 | 3.3 | |
Cesarean delivery | 51.7 | 52.8 | 31.0 | 12.7 | |
Small for gestational age (SGA) | 3.4 | 1.8 | 3.6 | 4.4 | <0.001 |
Apgar score 1 min < 7 | 49.2 | 28.1 | 10.2 | 4.1 | <0.001 |
Apgar score 5 min < 7 | 14.4 | 6.2 | 2.5 | 1.4 | <0.001 |
Neurological Morbidity of the Offspring | Extreme PTB (n = 118) (%) | Very PTB (n = 776) (%) | Moderate-Late PTB (n = 13,308) (%) | Term Birth n= (206,361) (%) | p-Value |
---|---|---|---|---|---|
Movement disorders | 4.2 | 3.5 | 2.7 | 1.8 | <0.001 |
Cerebral palsy | 4.2 | 0.9 | 0.2 | 0.1 | <0.001 |
Psychiatric disorders | 2.5 | 0.9 | 0.7 | 0.5 | <0.001 |
Developmental disorders | 0.8 | 0.3 | 0.2 | 0.1 | <0.001 |
Degenerative disorders | 0 | 0.6 | 0.1 | 0.1 | <0.001 |
Total Neurologic Related Hospitalizations | Cerebral Palsy | |||||
---|---|---|---|---|---|---|
Gestational Age | aHR * | 95% CI | p-Value | aHR ** | 95% CI | p-Value |
Term delivery (reference) >37 gestational weeks | 1 | - | - | 1 | - | - |
Moderate to late preterm | 1.3 | 1.2–1.5 | <0.001 | 2.5 | 1.6–3.9 | <0.001 |
Very preterm | 1.9 | 1.4–2.5 | <0.001 | 13.4 | 6.2–28.7 | <0.001 |
Extremely preterm | 3.9 | 2.3–6.6 | <0.001 | 62.4 | 25.6–152.4 | <0.001 |
Total Neurologic Related Hospitalizations | ||||
---|---|---|---|---|
Gestational Age | aHR * | 95% CI | p-Value | |
Model 1 | PTB 25 gestational week versus other later weeks of PTB | 5.9 | 2.2–15.9 | <0.001 |
Model 2 | PTB 26 gestational week versus other later weeks of PTB | 2.9 | 1.4–6.2 | <0.004 |
Model 3 | PTB 27 gestational week versus other later weeks of PTB | 2.4 | 1.4–4.2 | <0.001 |
Model 4 | PTB 28 gestational week versus other later weeks of PTB | 2.3 | 1.5–3.5 | <0.001 |
Model 5 | PTB 29 gestational week versus other later weeks of PTB | 2.1 | 1.4–3.0 | <0.001 |
Model 6 | PTB 30 gestational week versus other later weeks of PTB | 1.6 | 1.2–2.2 | <0.002 |
Model 7 | PTB 31 gestational week versus other later weeks of PTB | 1.5 | 1.1–1.9 | <0.002 |
Model 8 | PTB 32 gestational week versus other later weeks of PTB | 1.4 | 1.1–1.7 | <0.003 |
Model 9 | PTB 33 gestational week versus other later weeks of PTB | 1.3 | 1.1–1.6 | <0.003 |
Model 10 | PTB 34 gestational week versus other later weeks of PTB | 1.2 | 1.0–1.4 | <0.03 |
Model 11 | PTB 35 gestational week versus other later weeks of PTB | 1.3 | 1.1–1.5 | <0.001 |
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Zer, S.; Wainstock, T.; Sheiner, E.; Miodownik, S.; Pariente, G. Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery. J. Clin. Med. 2021, 10, 2919. https://doi.org/10.3390/jcm10132919
Zer S, Wainstock T, Sheiner E, Miodownik S, Pariente G. Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery. Journal of Clinical Medicine. 2021; 10(13):2919. https://doi.org/10.3390/jcm10132919
Chicago/Turabian StyleZer, Shiran, Tamar Wainstock, Eyal Sheiner, Shayna Miodownik, and Gali Pariente. 2021. "Identifying the Critical Threshold for Long-Term Pediatric Neurological Hospitalizations of the Offspring in Preterm Delivery" Journal of Clinical Medicine 10, no. 13: 2919. https://doi.org/10.3390/jcm10132919