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Childhood Respiratory Morbidity after Late Preterm and Early Term Delivery: a Study of Medicaid Patients in S outh C arolina
Author(s) -
Odibo Imelda N.,
Bird T. Mac,
McKelvey Samantha S.,
Sandlin Adam,
Lowery Curtis,
Magann E. F.
Publication year - 2016
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12250
Subject(s) - medicine , hazard ratio , pediatrics , confidence interval , medicaid , proportional hazards model , health care , economics , economic growth
Background There is a growing body of research documenting an increased risk of neonatal morbidity for late preterm infants ( LPI , 34 0/7 weeks to 36 6/7 weeks) and early term infants ( ETI , 37 0/7 weeks to 38 6/7 weeks) compared with term infants ( TI , 39 0/7 to 41 6/7 ); however, there has been little research on outcomes beyond the first year of life. In this study, we examined respiratory outcomes of LPI and ETI in early childhood. Methods S outh C arolina Medicaid claims data for maternal delivery and infant birth hospitalisations were linked to vital records data for the years 2000 through 2003. Medicaid claims for all infants were then followed until their fifth birthday or until a break in their eligibility. Infants born between 34 0/7 and 41 6/7 weeks were eligible. Infants with congenital anomaly, birthweight below 500 g or above 6000 g, and multiple births were excluded. We fit Cox proportional hazard models from which adjusted hazard ratio ( HR ) and 95% confidence interval ( CI ) were derived. Results A total of 3476 LPI , 12 398 ETI , and 25 975 term infants were included. Both LPI and ETI were associated with an increased risk for asthma ( LPI : HR 1.24, 95% CI 1.10, 1.40; ETI : HR 1.12, 95% CI 1.06, 1.19), and bronchitis ( LPI : HR 1.15, 95% CI 1.00, 1.34; ETI : HR 1.13, 95% CI 1.05, 1.2) at 3 to 5 years of age. Conclusions Late preterm infants and early term infants are at increased risk for asthma and bronchitis.