The following is a summary of “Resource and Service Use after Discharge among Infants Born 22-25 Weeks’ Gestation at the First High-risk Infant Follow-up Visit,” published in the June 2024 issue of Pediatrics by Pai et al.

This study investigates the utilization of resources and services following discharge among infants born extremely preterm in California who attended high-risk infant follow-up (HRIF) clinics by 12 months corrected age (CA).

The study cohort included infants born between 2010 and 2017 with gestational ages ranging from 22+0/7 to 25+6/7 weeks, identified from the California Perinatal Quality Care Collaborative (CPQCC) and CPQCC-California Children’s Services HRIF databases. Various metrics of healthcare utilization were assessed, encompassing hospitalizations, surgeries, medication usage, provision of medical equipment, medical and special service engagement, and referral patterns. Statistical analyses focused on identifying factors associated with receiving more than two medical services and more than one special service.

Out of 5,284 eligible infants, 3,941 attended an HRIF visit by 12 months CA. Infants born at earlier gestational ages exhibited higher utilization rates across all measured healthcare resources, including medications, equipment, medical services, special services, and referrals during their initial HRIF visit. Factors such as major morbidity, surgical interventions, caregiver-reported concerns, and maternal education levels were significant predictors of increased utilization of medical services. Conversely, infants of Black maternal race, younger maternal age, female sex, and those discharged from lower-level neonatal intensive care units (NICUs) were less likely to receive multiple medical services. Moreover, higher maternal education, multiple gestation, major morbidity, surgical history, caregiver concerns, and discharge from lower-level NICUs were associated with an increased likelihood of receiving special services.

This study underscores the substantial healthcare resource utilization among infants born extremely preterm following discharge. The findings highlight the influence of maternal and sociodemographic factors alongside expected clinical variables on resource utilization patterns. Early insights into functional outcomes and service utilization are crucial for parental preparation and emphasize the role of NICU providers in effectively guiding and referring families post-discharge.

Source: sciencedirect.com/science/article/pii/S0022347624002750