Discharge Age and Weight for Very Preterm Infants in Six Countries: 2012-2020

Erika M Edwards; Lucy T Greenberg; Jeffrey D Horbar; Luigi Gagliardi; Mark Adams; Angelika Berger; Sara Leitao; Karen Luyt; Danielle E Y Ehret; Jeannette A Rogowski

doi:10.1159/000528013

Discharge Age and Weight for Very Preterm Infants in Six Countries: 2012-2020

Neonatology. 2023;120(2):208-216. doi: 10.1159/000528013. Epub 2023 Jan 17.

Authors

Erika M Edwards^{1

2

3}, Lucy T Greenberg^{1

3}, Jeffrey D Horbar^{1

2}, Luigi Gagliardi⁴, Mark Adams⁵, Angelika Berger⁶, Sara Leitao⁷, Karen Luyt⁸, Danielle E Y Ehret^{1

2}, Jeannette A Rogowski⁹

Affiliations

¹ Vermont Oxford Network, Burlington, Vermont, USA.
² Department of Pediatrics, Robert Larner, MD, College of Medicine, University of Vermont, Burlington, Vermont, USA.
³ Department of Mathematics and Statistics, College of Engineering and Mathematical Sciences, University of Vermont, Burlington, Vermont, USA.
⁴ Division of Neonatology and Pediatrics, Ospedale Versilia, Viareggio, AUSL Toscana Nord Ovest, Pisa, Italy.
⁵ Newborn Research, Department of Neonatology, University and University Hospital Zurich, Zurich, Switzerland.
⁶ Division of Neonatology, Department of Pediatrics, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University Vienna, Vienna, Austria.
⁷ National Perinatal Epidemiology Centre, Department of Obstetrics and Gynecology, Cork University College Cork, Cork, Ireland.
⁸ Bristol Medical School, University of Bristol, Bristol, UK.
⁹ Department of Health Policy and Administration, The Pennsylvania State University, State College, Pennsylvania, USA.

PMID: 36649689
DOI: 10.1159/000528013

Abstract

Background: Postmenstrual age for surviving infants without congenital anomalies born at 24-29 weeks' gestational age from 2005 to 2018 in the USA increased 8 days, discharge weight increased 316 grams, and median discharge weight z-score increased 0.19 standard units. We asked whether increases were observed in other countries.

Methods: We evaluated postmenstrual age, weight, and weight z-score at discharge of surviving infants without congenital anomalies born at 24-29 weeks' gestational age admitted to Vermont Oxford Network member hospitals in Austria, Ireland, Italy, Switzerland, the UK, and the USA from 2012 to 2020.

Results: After adjustment, the median postmenstrual age at discharge increased significantly in Austria (3.6 days, 99% CI [1.0, 6.3]), Italy (4.0 days [2.3, 5.6]), and the USA (5.4 days [5.0, 5.8]). Median discharge weight increased significantly in Austria (181 grams, 99% CI [95, 267]), Ireland (234 [143, 325]), Italy (133 [83, 182]), and the USA (207 [194, 220]). Median discharge weight z-score increased in Ireland (0.24 standard units, 99% CI [0.12, 0.36]) and the USA (0.15 [0.13, 0.16]). Discharge on human milk increased in Italy, Switzerland, and the UK, while going home on cardiorespiratory monitors decreased in Austria, Ireland, and USA and going home on oxygen decreased in Ireland.

Conclusions: In this international cohort of neonatal intensive care units, postmenstrual discharge age and weight increased in some, but not all, countries. Processes of care at discharge did not change in conjunction with age and weight increases.

Keywords: Length of stay; Neonatology; Preterm infants; Utilization.

MeSH terms

Gestational Age
Humans
Infant
Infant, Newborn
Infant, Premature*
Infant, Premature, Diseases*
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Patient Discharge