Long-Term Infectious Morbidity of Premature Infants: Is There a Critical Threshold?
Abstract
:1. Introduction
2. Methods
Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Extreme PTB (n = 125) (%) | Very PTB (n = 784) (%) | Moderate to Late PTB (n = 13,323) (%) | Term Births (n = 206,362) (%) | p-Value | |
---|---|---|---|---|---|---|
Maternal Age | 28.47 | 28.36 | 28.31 | 28.24 | 0.482 | |
Parity | 1 | 38.1 | 31.4 | 29.0 | 24.2 | <0.001 |
2–4 | 48.3 | 47.7 | 47.7 | 52.0 | ||
5+ | 13.6 | 20.9 | 23.3 | 23.8 | ||
Mode of delivery | Vaginal | 48.3 | 46.5 | 67.3 | 83.9 | <0.001 |
Assisted | 0.0 | 0.6 | 1.7 | 3.3 | ||
Cesarean | 51.7 | 52.8 | 31.0 | 12.7 | ||
Birthweight (grams) | 1096.13 ± 601.4 | 1644.43 ± 633.4 | 2540.32 ± 495.3 | 3270.5 ± 455.6 | <0.001 | |
Maternal diabetes | 0.0 | 6.2 | 8.1 | 5.2 | <0.001 | |
Hypertensive disorders | 8.5 | 19.1 | 12.9 | 4.7 | <0.001 |
Infectious Morbidity | Gestational Age at Delivery (Weeks) | p-Value | |||
---|---|---|---|---|---|
24 + 0–27 + 6 (n = 125) N (%) | 28 + 0–31 + 6 (n = 784) N (%) | 32 + 0–36 + 6 (n = 13,323) N (%) | ≥37 + 0 (n = 206,362) N (%) | ||
Bacterial infections | 1 (0.8) | 9 (1.1) | 19 (0.1) | 269 (0.1) | <0.001 |
Viral infections | 4 (3.2) | 14 (1.8) | 151 (1.1) | 1773 (0.9) | <0.001 |
ENT infections | 4 (3.2) | 20 (2.6) | 281 (2.1) | 3060 (1.5) | <0.001 |
GI infections | 1 (0.8) | 22 (2.8) | 263 (2.0) | 3448 (1.7) | 0.004 |
Invasive bacterial infections | 4 (3.2) | 11 (1.4) | 29 (0.2) | 190 (0.1) | <0.001 |
Neonatal infections | 2 (1.6) | 5 (0.6) | 55 (0.4) | 549 (0.3) | <0.001 |
Ophthalmic infections | 1 (0.8) | 4 (0.5) | 55 (0.4) | 612 (0.3) | 0.053 |
Orthopedic infections | 0 (0.0) | 5 (0.6) | 25 (0.2) | 315 (0.2) | 0.005 |
Respiratory infections | 10 (8.0) | 70 (8.9) | 1086 (8.2) | 11,208 (5.4) | <0.001 |
Skin infections | 4 (3.2) | 6 (0.8) | 122 (0.9) | 1702 (0.8) | 0.02 |
Urologic infections | 2 (1.6) | 15 (1.9) | 144 (1.1) | 1330 (0.6) | <0.001 |
Total infectious-related hospitalizations | 23 (18.4) | 155 (19.8) | 1986 (14.9) | 22,610 (11.0) | <0.001 |
Gestational Age at Delivery (Weeks) | Age at Infectious-Related Hospitalization (Years) | p-Value | |
---|---|---|---|
Mean ± SD | Median | ||
24 + 0–27 + 6 | 1.852 ± 2.35 | 0.715 | <0.001 |
28 + 0–31 + 6 | 2.088 ± 3.57 | 0.756 | |
32 + 0–36 + 6 | 2.812 ± 4.054 | 0.993 | |
≥37 + 0 | 3.317 ± 4.36 | 1.263 |
Gestational Age (Weeks) | Spontaneous Labor n (%) | Induced Labor n (%) | p-Value |
---|---|---|---|
24 + 0–27 + 6 | 21 (18.6) | 2 (16.7) | <0.001 |
28 + 0–31 + 6 | 142 (20.0) | 13 (17.6) | |
32 + 0–36 + 6 | 1521 (14.8) | 465 (15.2) | |
≥37 + 0 | 15,914 (10.6) | 6696 (11.8) | |
Total hospitalizations | 17,598 (11.0) | 7176 (12.0) |
Gestational Age (Weeks) | Total | ||
---|---|---|---|
Adjusted HR | 95% CI | p-Value | |
≥37 + 0 | 1 | ||
32 + 0–36 + 6 | 1.27 | 1.206–1.335 | <0.001 |
28 + 0–31 + 6 | 1.55 | 1.317–1.832 | <0.001 |
24 + 0–27 + 6 | 1.48 | 0.976–2.231 | 0.065 |
Maternal age | 0.987 | 0.984–0.989 | <0.001 |
Birthweight | 1 | 1.000–1.000 | <0.001 |
Maternal diabetes | 1.194 | 1.131–1.261 | <0.001 |
Hypertensive disorders | 1.044 | 0.988–1.103 | 0.128 |
Cesarean delivery | 1.076 | 1.039–1.115 | <0.001 |
Year of birth | 1.107 | 1.105–1.110 | <0.001 |
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Davidesko, S.; Wainstock, T.; Sheiner, E.; Pariente, G. Long-Term Infectious Morbidity of Premature Infants: Is There a Critical Threshold? J. Clin. Med. 2020, 9, 3008. https://doi.org/10.3390/jcm9093008
Davidesko S, Wainstock T, Sheiner E, Pariente G. Long-Term Infectious Morbidity of Premature Infants: Is There a Critical Threshold? Journal of Clinical Medicine. 2020; 9(9):3008. https://doi.org/10.3390/jcm9093008
Chicago/Turabian StyleDavidesko, Sharon, Tamar Wainstock, Eyal Sheiner, and Gali Pariente. 2020. "Long-Term Infectious Morbidity of Premature Infants: Is There a Critical Threshold?" Journal of Clinical Medicine 9, no. 9: 3008. https://doi.org/10.3390/jcm9093008