Increased risk of morbidities and health‐care utilisation in children born following preterm labour compared with full‐term labour: A population‐based study

• Published in: Journal of paediatrics and child health 2019-04, Vol.55 (4), p.446-453
• Main Authors: Houben, Eline, Smits, Elisabeth, Pimenta, Jeanne M, Black, Libby K, Bezemer, Irene D, Penning‐van Beest, Fernie JA
• Format: Article
• Language: English
• Subjects: Childrens health; Clinical outcomes; follow‐up studies; Health risk assessment; Health services utilization; Intensive care; labour onset; Long term; morbidity; Neonatal care; neonatal intensive care; Newborn babies; Population-based studies; Premature birth; preterm birth; retrospective study
• ISSN: 1034-4810; 1440-1754
• DOI: 10.1111/jpc.14225

Aim Recent evidence is emerging indicating long‐term effects in infants born after an episode of preterm labour (PTL), even if birth is at term. This population‐based study compared long‐term rates of outcomes and health‐care utilisation (HCU) in children born following spontaneous preterm labour, irrespective of gestational age at delivery or of an uncomplicated pregnancy (SPTLu), with children born following full‐term labour (FTL), overall stratified by comorbidity status and assessed using a composite morbidity measure (CM). Methods Retrospective data on mother–neonate pairs were collected from a patient‐linked dataset from the Netherlands Perinatal Registry and the PHARMO Database Network. Children born between 2000 and 2010 were followed until 2012. Results Of pregnancies in 134 006 mother–neonate pairs, 122 894 (92%) pregnancies resulted in FTL, and 11 112 (8%) resulted in PTL. Of the PTL pregnancies, 6599 (59%) were SPTLu. Mean follow‐up after birth was 6.6–6.7 years. Children from SPTLu pregnancies were at increased risk of neurodevelopmental and respiratory conditions compared with those from FTL pregnancies. In children from SPTLu pregnancies, the presence of the CM was associated with an increased risk of respiratory conditions and failure to thrive. Post‐natal hospitalisations (incidence rate (IR) per 100 patient‐years: 18.1 vs. 11.7) and specialist referrals (IR per 1000 patient‐years: 290.6 vs. 184.5) occurred significantly more frequently in children from SPTLu versus FTL pregnancies. Conclusion The increased risk of morbidities and HCU in children born following SPTLu pregnancy in this population‐based setting reinforces the need for safe interventions that can effectively halt labour and lead to an improvement in childhood outcomes.