Abstract
Objective The late preterm population [34–36 weeks gestational age (GA)] is known to incur increased morbidity in the infancy stage compared to the population born at term (39–41 weeks GA). This study aimed to examine the health of these children during their early childhood years, with specific attention to the role of socioeconomic status. Methods A retrospective cohort study was conducted using data from the Manitoba Centre for Health Policy, including all live-born children born at 34–36 and 39–41 weeks GA in urban Manitoba between 2000 and 2005 (n = 28,100). Multivariable logistic regression was used to examine the association of GA with early childhood morbidity after controlling for maternal, child and family level variables. Results The late preterm population was found to have significantly greater adjusted odds of lower respiratory tract infections in the preschool years (aOR = 1.59 [1.24, 2.04]) and asthma at school age (aOR = 1.33 [1.18, 1.47]) compared to the population born at term. The groups also differed in health care utilization at ages 4 (aOR = 1.19 [1.06,1.34]) and 7 years (aOR = 1.24 [1.09, 1.42]). Additional variables associated with poor outcomes suggest that social deprivation and GA simultaneously have a negative impact on early childhood development. Conclusions for Practice Adjustment for predictors of poor early childhood development, including socioeconomic status, were found to attenuate but not eliminate health differences between children born late preterm and children born at term. Poorer health outcomes that extend into childhood have implications for practice at the population level and suggest a need for further follow-up post discharge.
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Acknowledgements
The authors acknowledge the Manitoba Centre for Health Policy for use of data contained in the Population Health Research Data Repository under project #2014017 (HIPC#2013/2014-48). The results and conclusions are those of the authors and no official endorsement by the Manitoba Centre for Health Policy, Manitoba Health, Seniors and Active Living, or other data providers is intended or should be inferred. LC acknowledges funding from a Western Regional Training Centre studentship funded by Canadian Institutes of Health Research (CIHR) and Manitoba Health, Seniors and Active Living. LC also acknowledges funding from Research Manitoba, the Children’s Hospital Research Institute of Manitoba, and the Evelyn Shapiro Award for Health Services Research. MD acknowledges the financial support of the Government of Manitoba through the Manitoba Centre for Health Policy Population-Based Child Health Research Award.
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Crockett, L.K., Brownell, M.D., Heaman, M.I. et al. Examining Early Childhood Health Outcomes of Children Born Late Preterm in Urban Manitoba. Matern Child Health J 21, 2141–2148 (2017). https://doi.org/10.1007/s10995-017-2329-5
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DOI: https://doi.org/10.1007/s10995-017-2329-5