Long-term gastrointestinal morbidity of premature infants: Is there a critical threshold?

Gali Pariente, Ofir Ohana, Tamar Wainstock, Eyal Sheiner

Research output: Contribution to journalMeeting Abstract

Abstract

Objective
Preterm birth (PTB) is highly associated with gastrointestinal (GI) morbidity of the premature infant. In this study we sought to ascertain a relationship between the degree of prematurity and long-term GI morbidity of the offspring.

Study Design
A population-based cohort analysis was conducted, comparing the long-term incidence of GI morbidity in infants born preterm according to gestational age at birth. Cases were divided into four groups according to the extremity of prematirity. GI morbidity included hospitalizations involving a predefined set of ICD9 codes, as recorded in hospital records. A Kaplan Meier survival curve was constructed to compare cumulative incidence of GI morbidity. A Cox proportional hazards model was used to control for confounders and for time to event.

Results
During the study period 220,563 patients met the inclusion criteria, of which 118 (0.1%) were extreme PTB, 776 (0.4%) were very PTB, 13,308 (6.0%) were moderate to late PTB and 206,361 were term deliveries. Offspring born preterm had significantly more hospitalizations due to GI morbidity compared to term offspring (P< 0.001,Table). The Kaplan Meier survival curve demonstrated significant higher cumulative incidence of long- term GI morbidity of the offspring with decreasing gestational age (Log rank p< 0.001, Figure). Using a Cox proportional hazards model, controlling for maternal age, birth weight, maternal diabetes mellitus, hypertensive diseases and mode of delivery, being born at very and late to moderate PTB was independently associated with long-term GI morbidity. Extremely early preterm deliveries at 24+0-27+6 weeks were also found in increased risk of long-term GI morbidity (HR 1.34) but this association did not achieve statistical significance.

Conclusion
Preterm delivery is an independent risk factor for long-term GI morbidity of the offspring, starting from 28 weeks. The lack of association between extreme PTB and long-term GI morbidity may be due to small number of patients in this group.
Original languageEnglish
Pages (from-to)S621-S621
JournalAmerican Journal of Obstetrics and Gynecology
Volume222
Issue number1
DOIs
StatePublished - Jan 2020

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