Trends in Costs of Birth Hospitalization and Readmissions for Late Preterm Infants

Background: The objective is to study previously unexplored trends of birth hospitalization and readmission costs for late preterm infants (LPIs) in the United States between 2005 and 2016. Methods: We conducted a retrospective analysis of claims data to study healthcare costs of birth hospitalization and readmissions for LPIs compared to term infants (TIs) using a large private insurance database. We used a generalized linear regression model to study birth hospitalization and readmission costs. Results: A total of 2,123,143 infants were examined (93.2% TIs; 6.8% LPIs). The proportion of LPIs requiring readmission was 4.2% compared to 2.1% of TIs, (p < 0.001). The readmission rate for TIs decreased during the study period. LPIs had a higher mean cost of birth hospitalization (25,700 vs. 3300 USD; p < 0.001) and readmissions (25,800 vs. 14,300 USD; p < 0.001). For LPIs, birth hospitalization costs increased from 2007 to 2013, and decreased since 2014. Conversely, birth hospitalization costs of TIs steadily increased since 2005. The West region showed higher birth hospitalization costs for LPIs. Conclusions: LPIs continue to have a higher cost of birth hospitalization and readmission compared to TIs, but these costs have decreased since 2014. Standardization of birth hospitalization care for LPIs may reduce costs and improve quality of care and outcomes.

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Late-preterm infants, early-term infants, and timing of elective deliveries; current status in a Korean medical center

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2017.1404564 ◽

2017 ◽

Vol 32 (8) ◽

pp. 1267-1274 ◽

Cited By ~ 1

Author(s):

Hyun Sun Ko ◽

Yu-ri Jang ◽

Hanggoo Yun ◽

JeongHa Wie ◽

Sae Kyung Choi ◽

...

Keyword(s):

Preterm Infants ◽

Medical Center ◽

Late Preterm ◽

Current Status ◽

Term Infants ◽

Early Term ◽

Late Preterm Infants ◽

Elective Deliveries

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Effects of Sex and Mild Intrainsult Hypothermia on Neuropathology and Neural Reorganization following Neonatal Hypoxic Ischemic Brain Injury in Rats

Neural Plasticity ◽

10.1155/2016/2585230 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 11

Author(s):

Amanda L. Smith ◽

Ted S. Rosenkrantz ◽

R. Holly Fitch

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Female Rats ◽

Future Research ◽

Term Infants ◽

Behavioral Deficits ◽

Clinical Issue ◽

Late Preterm Infants ◽

Male And Female Rats ◽

Compare And Contrast

Hypoxia ischemia (HI) is a recognized risk factor among late-preterm infants, with HI events leading to varied neuropathology and cognitive/behavioral deficits. Studies suggest a sex difference in the incidence of HI and in the severity of subsequent behavioral deficits (with better outcomes in females). Mechanisms of a female advantage remain unknown but could involve sex-specific patterns of compensation to injury. Neuroprotective hypothermia is also used to ameliorate HI damage and attenuate behavioral deficits. Though currently prescribed only for HI in term infants, cooling has potential intrainsult applications to high-risk late-preterm infants as well. To address this important clinical issue, we conducted a study using male and female rats with a postnatal (P) day 7 HI injury induced under normothermic and hypothermic conditions. The current study reports patterns of neuropathology evident inpostmortemtissue. Results showed a potent benefit of intrainsult hypothermia that was comparable for both sexes. Findings also show surprisingly different patterns of compensation in the contralateral hemisphere, withincreasesin hippocampal thickness in HI females contrastingreducedthickness in HI males. Findings provide a framework for future research to compare and contrast mechanisms of neuroprotection and postinjury plasticity in both sexes following a late-preterm HI insult.

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Admissions and Emergency Visits by Late Preterm Singletons and Twins in the First 5 Years: A Population-Based Cohort Study

American Journal of Perinatology ◽

10.1055/s-0039-3402718 ◽

2019 ◽

Cited By ~ 1

Author(s):

Tetsuya Isayama ◽

Daria O'Reilly ◽

Joseph Beyene ◽

Shoo K. Lee ◽

Prakesh S. Shah ◽

...

Keyword(s):

Cohort Study ◽

Preterm Infants ◽

Population Based ◽

Late Preterm ◽

Administrative Database ◽

Term Infants ◽

Emergency Visits ◽

Late Preterm Infants ◽

Adjusted Incidence Rate ◽

The Difference

Abstract Objective To compare admission and emergency visits of late preterm (340/7–366/7 weeks) versus term infants (370/7–416/7 weeks) in the first 5 years. Study Design This population-based cohort study included all singletons and twins born alive at 340/7 to 416/7 weeks' gestation registered in a health administrative database in Ontario, Canada, between April 1, 2002 and December 31, 2012. Admissions and emergency visits from initial postnatal discharge to 5 years were compared between late preterm and term infants adjusting for maternal and infant characteristics. Results A total of 1,316,931 infants (75,364 late preterm infants) were included. Late preterm infants had more frequent admissions than term infants in the first 5 years in both singletons (adjusted incidence rate ratio [95% confidence interval] = 1.46 [1.42–1.49]) and twins (1.21 [1.11–1.31]). The difference in admissions between late preterm and term infants were smaller in twins than singletons and decreased with children's ages. Twins had less frequent admissions than singletons for late preterm infants, but not for term infants. The emergency visits were more frequent in late preterm than term infants in all the periods. Conclusion Admissions and emergency visits were more frequent in late preterm than term infants through the first 5 years. Admissions were less frequent in late preterm twins than singletons.

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Competence and Responsiveness in Mothers of Late Preterm Infants Versus Term Infants

Journal of Obstetric Gynecologic & Neonatal Nursing ◽

10.1111/1552-6909.12026 ◽

2013 ◽

Vol 42 (3) ◽

pp. 301-310 ◽

Cited By ~ 5

Author(s):

Brenda Baker ◽

Jacquelin.M. McGrath ◽

Rita Pickler ◽

Nancy Jallo ◽

Stephen Cohen

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Term Infants ◽

Late Preterm Infants

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Morbidity profile and immediate outcome of late preterm neonates compared to term neonates in a rural tertiary care hospital of Gujarat

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20172660 ◽

2017 ◽

Vol 4 (4) ◽

pp. 1329 ◽

Cited By ~ 1

Author(s):

Manish Rasania ◽

Prasad Muley

Keyword(s):

Preterm Infants ◽

Tertiary Care ◽

Preterm Births ◽

Full Term ◽

Late Preterm ◽

Preterm Neonates ◽

Care Hospital ◽

Term Infants ◽

Term Neonates ◽

Late Preterm Infants

Background: Late premature infants are born near term, but are immature. As a consequence, late preterm infants are at higher risk than term infants to develop morbidities. Although late preterm infants are the largest subgroup of preterm infants, there is a very limited data available on problems regarding late preterm infants in rural India.Methods: This is a retrospective cohort study using previously collected data from neonates born at Dhiraj Hospital and neonates who were born outside but admitted at SNCU of Dhiraj Hospital, Piparia, Vadodara district, Gujarat, India between January 2015 to December 2015.Results: 168 late preterm infants and 1025 term infants were included in this study. The need for SNCU admission is significantly higher in late preterm compared to full term (41.07% vs 2.04%). Morbidities were higher in late preterm neonates compared to full term neonates. Sepsis (4.76% vs 1.07%), TTN (10.11% vs 2.04%), hyperbilirubinemia (19.04% vs 9.36%), RDS (1.78% vs 0.09%), hypoglycemia (1.78% vs 0.29%), PDA (1.78% vs 0.58%), risk of major congenital malformation (2.38% vs 0.58%). Need for respiratory support was 5.95% in late preterm vs 2.04% in full term neonates. Immediate neonatal outcome in terms of death and DAMA (non-salvageable) cases was poor in late preterm neonates compared to full term neonates (1.19% vs 0.78%).Conclusions: Late preterm neonates are at higher risk of morbidities and mortalities. They require special care. Judicious obstetric decisions are required to prevent late preterm births.

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