Patterns of respiratory health services utilization from birth to 5 years of children who experienced adverse birth outcomes

PLoS One. 2021 Feb 19;16(2):e0247527. doi: 10.1371/journal.pone.0247527. eCollection 2021.

Abstract

Introduction: Adverse birth outcomes have important consequences for future lung health. We evaluated patterns of respiratory health services utilization in early childhood among children born preterm (PTB), small and large for gestational age at term (SGA and LGA, respectively), and appropriate-for-gestational age at term.

Materials and methods: We conducted a population-based retrospective cohort study using administrative health data of all singleton live births in Alberta, Canada between 2005-2010. Data on hospitalizations and emergency department (ED) visits from birth to 5 years were collected for asthma, bronchitis, bronchiolitis, croup, influenza, pneumonia, and other acute upper and lower respiratory tract infections (other URTI and other LRTI, respectively). Adjusted rate ratios were estimated for respiratory ED visits and hospitalizations for adverse birth outcomes using the appropriate-for-gestational age at term group as reference. Age-specific trajectories of total respiratory health services utilization rates for each group were estimated in Poisson models.

Results: A total of 293,764 episodes of respiratory care from 206,994 children were analyzed. Very PTB children had the highest rates of health services use for all respiratory conditions, particularly for asthma, pneumonia, and bronchiolitis hospitalizations. Moderate/late PTB children also had elevated ED visits and hospitalizations for all respiratory conditions. Children born SGA showed high rates of ED visits for other LRTI, and of hospitalizations for bronchitis, bronchiolitis, and other URTI. Children born LGA had high rates of croup and other URTI ED visits, and of bronchiolitis and bronchiolitis hospitalizations. Age-specific trajectories showed a decreasing trend in the rates of total respiratory health service utilization from birth to five years of age for all groups studied. Children born PTB and LGA at term significantly required more respiratory health services over time compared to the reference group.

Conclusion: Patterns of paediatric respiratory health services utilization vary according to gestational age and fetal growth.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Emergency Service, Hospital*
  • Female
  • Hospitalization*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Patient Acceptance of Health Care*
  • Respiratory Tract Diseases / therapy*
  • Respiratory Tract Infections / therapy*
  • Retrospective Studies

Grants and funding

This research was funded by the Lois Hole Hospital for Women through a Women and Children’s Health Research Institute Recruitment Award (MBO) (https://www.wchri.org), and the Lung Association Alberta & NWT through the 2017-2018 National Grant Review program (https://www.ab.lung.ca/what-we-do/research/grant-opportunities/national-grant-review). MBO’s research is supported by the Canada Research Chair Program (Government of Canada; Ottawa, Canada). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.