Morbidity and trends in length of hospitalisation of very and extremely preterm infants born between 2008 and 2021 in the Netherlands: a cohort study

Objectives This study investigated changes in the length of stay (LoS) at a level III/IV neonatal intensive care unit (NICU) and level II neonatology departments until discharge home for very preterm infants and identified factors influencing these trends.Design Retrospective cohort study based on d...

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Main Authors: Floris Groenendaal, Kees Ahaus, Karen de Bijl-Marcus, Manon J N L Benders, Jeroen Dudink, Marijn Kahlmann
Format: Article
Language:English
Published: BMJ Publishing Group 2024-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/6/e078842.full
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author Floris Groenendaal
Kees Ahaus
Karen de Bijl-Marcus
Manon J N L Benders
Jeroen Dudink
Marijn Kahlmann
author_facet Floris Groenendaal
Kees Ahaus
Karen de Bijl-Marcus
Manon J N L Benders
Jeroen Dudink
Marijn Kahlmann
author_sort Floris Groenendaal
collection DOAJ
description Objectives This study investigated changes in the length of stay (LoS) at a level III/IV neonatal intensive care unit (NICU) and level II neonatology departments until discharge home for very preterm infants and identified factors influencing these trends.Design Retrospective cohort study based on data recorded in the Netherlands Perinatal Registry between 2008 and 2021.Setting A single level III/IV NICU and multiple level II neonatology departments in the Netherlands.Participants NICU-admitted infants (n=2646) with a gestational age (GA) <32 weeks.Main outcome measures LoS at the NICU and overall LoS until discharge home.Results The results showed an increase of 5.1 days (95% CI 2.2 to 8, p<0.001) in overall LoS in period 3 after accounting for confounding variables. This increase was primarily driven by extended LoS at level II hospitals, while LoS at the NICU remained stable. The study also indicated a strong association between severe complications of preterm birth and LoS. Treatment of infants with a lower GA and more (severe) complications (such as severe retinopathy of prematurity) during the more recent periods may have increased LoS.Conclusion The findings of this study highlight the increasing overall LoS for very preterm infants. LoS of very preterm infants is presumably influenced by the occurrence of complications of preterm birth, which are more frequent in infants at a lower gestational age.
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spelling doaj-art-8e4df7a9be594153ad0629d0130d2d7f2025-08-20T03:42:40ZengBMJ Publishing GroupBMJ Open2044-60552024-06-0114610.1136/bmjopen-2023-078842Morbidity and trends in length of hospitalisation of very and extremely preterm infants born between 2008 and 2021 in the Netherlands: a cohort studyFloris Groenendaal0Kees Ahaus1Karen de Bijl-Marcus2Manon J N L Benders3Jeroen Dudink4Marijn Kahlmann51 Department of Neonatology, Universitair Medisch Centrum Utrecht-Locatie Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands1 Erasmus School of Health Policy & Management, Department Health Services Management & Organization, Erasmus University Rotterdam, Rotterdam, The Netherlands1 Department of Neonatology, Universitair Medisch Centrum Utrecht-Locatie Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands1 Department of Neonatology, Universitair Medisch Centrum Utrecht-Locatie Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands1 Department of Neonatology, Universitair Medisch Centrum Utrecht-Locatie Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands1 Department of Neonatology, Universitair Medisch Centrum Utrecht-Locatie Wilhelmina Kinderziekenhuis, Utrecht, The NetherlandsObjectives This study investigated changes in the length of stay (LoS) at a level III/IV neonatal intensive care unit (NICU) and level II neonatology departments until discharge home for very preterm infants and identified factors influencing these trends.Design Retrospective cohort study based on data recorded in the Netherlands Perinatal Registry between 2008 and 2021.Setting A single level III/IV NICU and multiple level II neonatology departments in the Netherlands.Participants NICU-admitted infants (n=2646) with a gestational age (GA) <32 weeks.Main outcome measures LoS at the NICU and overall LoS until discharge home.Results The results showed an increase of 5.1 days (95% CI 2.2 to 8, p<0.001) in overall LoS in period 3 after accounting for confounding variables. This increase was primarily driven by extended LoS at level II hospitals, while LoS at the NICU remained stable. The study also indicated a strong association between severe complications of preterm birth and LoS. Treatment of infants with a lower GA and more (severe) complications (such as severe retinopathy of prematurity) during the more recent periods may have increased LoS.Conclusion The findings of this study highlight the increasing overall LoS for very preterm infants. LoS of very preterm infants is presumably influenced by the occurrence of complications of preterm birth, which are more frequent in infants at a lower gestational age.https://bmjopen.bmj.com/content/14/6/e078842.full
spellingShingle Floris Groenendaal
Kees Ahaus
Karen de Bijl-Marcus
Manon J N L Benders
Jeroen Dudink
Marijn Kahlmann
Morbidity and trends in length of hospitalisation of very and extremely preterm infants born between 2008 and 2021 in the Netherlands: a cohort study
BMJ Open
title Morbidity and trends in length of hospitalisation of very and extremely preterm infants born between 2008 and 2021 in the Netherlands: a cohort study
title_full Morbidity and trends in length of hospitalisation of very and extremely preterm infants born between 2008 and 2021 in the Netherlands: a cohort study
title_fullStr Morbidity and trends in length of hospitalisation of very and extremely preterm infants born between 2008 and 2021 in the Netherlands: a cohort study
title_full_unstemmed Morbidity and trends in length of hospitalisation of very and extremely preterm infants born between 2008 and 2021 in the Netherlands: a cohort study
title_short Morbidity and trends in length of hospitalisation of very and extremely preterm infants born between 2008 and 2021 in the Netherlands: a cohort study
title_sort morbidity and trends in length of hospitalisation of very and extremely preterm infants born between 2008 and 2021 in the netherlands a cohort study
url https://bmjopen.bmj.com/content/14/6/e078842.full
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