The influence of late prematurity on the length of birth hospitalization

IZHODIŠČA. Pojavnost prezgodnjih porodov narašča. Večino prezgodaj rojenih otrok predstavljajo blago nedonošeni novorojenčki (gestacijska starost od 34 sup 0/7 (34 tednov in 0 dni) do 36 sup 6/7). Prisotna je potreba po testiranju hipoteze, da pogostejša obolevnost v tej skupini pomembno podaljšuje dolžino bivanja v porodnišnici. METODE. V retrospektivno raziskavo smo zajeli populacijo novorojenčkov, rojenih na Oddelku za perinatologijo Univerzitetnega kliničnega centra Maribor v letu 2008 z gestacijsko starostjo od 34 do 42 tednov. Podatke smo pridobili iz dveh podatkovnih baz, in sicer iz Perinatalnega informacijskega sistema Slovenije in Medicinskega informacijskega sistema Univerzitetnega kliničnega centra Maribor. Novorojenčke smo razdelili v skupino donošenih (n = 1.861) in skupino blago nedonošenih novorojenčkov (n = 100). Enota preučevanja je bila dolžina bivanja v bolnišnici po rojstvu. Preiskovali smo naslednje spremenljivke in njihov medsebojni vpliv na dolžino bivanja v bolnišnici: način poroda, dihalna stiska, obporodne okužbe, zlatenica in dehidracija. REZULTATI. Povprečna dolžina bivanja v bolnišnici je bila pri blago nedonošenih novorojenčkih 7,7 dni, pri donošenih pa 4,2 dni. Razlika je bila statistično značilna (p < 0,001). Statistično značilno pogostejši carski rez v skupini blago nedonošenih in značilno pogostejša pojavnost opazovanih spremenljivk (dihalna stiska, obporodne okužbe, zlatenica, dehidracija) in njihova obravnava so statistično pomembno podaljšali bivanje v bolnišnici. ZAKLJUČKI. Rezultati raziskave so potrdili hipotezo o statistično pomembno povečani obolevnosti v skupini blago nedonošenih novorojenčkov in pomembno povečani potrebi po obravnavi v enoti posebne nege ter podaljšanem bivanju v bolnišnici po rojstvu. Zato je potrebno trezno odločanje zlasti ob indukciji poroda ali elektivnem carskem rezu v zgodnejših terminih.BACKGROUNDS. The frequency of preterm deliveries is increasing and late preterm newborns (from 34 sup 0/7 to 36 sup 6/7 weeks of gestation) represent the majority of preterm infants. There was therefore a need to test the hypothesis that the higher incidence of morbidity in this group significantly prolongs their hospital stay following birth. METHODS. This was a population based study in newborns born between 34 and 42 weeks of gestation from January 2008 to January 2009 at the Department of perinatology of the Maribor university clinical center. The data were taken from two medical record databases: Perinatal information system of Slovenia and Medical information system of the Maribor university clinical center. This birth cohort was divided into term (n=1.861) and late preterm groups (n=100). The objective of our investigation was the length of hospital stay. The analysed variables were: mode of delivery, respiratory morbidity, neonatal infections, jaundice, and dehydration. These variables were compared between the investigated groups and their influence on hospital stay was studied. RESULTS. The average length of hospital stay was 7.7 days for late preterm and 4.2 days for term newborns, and this difference was statistically significant (p < 0.001). Significantly higher rates of cesarean sections in late preterm infants and significantly higher incidences of respiratory morbidity, neonatal infections, jaundice, and dehydration along with their treatment significantly prolonged their hospital stay. CONCLUSIONS. The results of our study confirmed the hypothesis that late preterm infants have significantly higher morbidity rates, a greater need for treatment in neonatal special care units, and significantly longer hospital stays following birth