Re-hospitalization in infants younger than 29 weeks' gestation in the EPIPAGE cohort

Aim: To estimate the re-hospitalization rate of extremely preterm children during infancy and associated factors after the recent improvement in survival rates. Method: The cohort included all children born before 29 wk of gestation in nine French regions in 1997. All admissions between discharge from initial hospitalization and 9 mo after birth were considered. Factors studied included the child's characteristics at birth and during neonatal hospitalization, risk factors for infection after discharge and parents' socio-demographic characteristics. Adjusted odds ratios (aOR) for re-hospitalization for all reasons and for respiratory disorders were obtained from logistic regression models. Results: Of the 376 children, 178 were re-admitted at least once (47.3%; 95% CI: 42.3-52.4). Fifty-five percent of the hospitalized children were admitted at least once for respiratory disorders. The re-hospitalization rate was higher for children who had had chronic lung disease (aOR: 2.2; 95% CI: 1.3-3.7), those initially discharged between August and October (aOR: 2.5; 95% CI: 1.2-5.1) or between November and January (aOR: 3.2; 95% CI: 1.5-6.8), and children living with other children under six (aOR: 3.4; 95 %CI: 1.6-7.5). Rehospitalizations were associated with neither gestational age nor the duration of neonatal hospitalization. Adjusted odds ratios for re-hospitalization for respiratory tract disorders were very similar to those for the overall hospitalizations. Conclusion: Infants born before 29 wk have a very high risk of re-hospitalization. The associated factors can help define high-risk groups at discharge from the neonatal unit who need special surveillance.