TOPLINE:

Most children born very preterm (< 32 weeks of gestation) required hospitalisation after neonatal discharge and before 2 years of age. Longer hospital stay was associated with lower gestational age and the number of major neonatal morbidities developed during the neonatal stay.

METHODOLOGY:

• Using routinely collected neonatal and hospital admission data, researchers examined hospital admissions after neonatal discharge and before 2 years of age among children born very preterm.
• They included 39,413 children born between 22 weeks 0 days and 31 weeks 6 days of gestation in England and Wales from January 2013 to December 2018 who were admitted for neonatal care after birth and were discharged home.
• The researchers assessed hospital admissions occurring after neonatal discharge and before 2 years of age, along with total hospitalisation days across these admissions.

TAKEAWAY:

• Overall, 67.2% of children experienced at least one episode of hospitalisation after neonatal discharge and before 2 years of age; the proportion increased from 58.8% among children born at 31 weeks of gestation to 87.0% among those born at less than 24 weeks of gestation.
• The median number of days hospitalised between neonatal discharge and the age of 2 years was 2 days across all admissions and was greater among children born at less than 24 weeks of gestation than among those born at 31 weeks of gestation (median, 8 vs 1 day).
• The presence of bronchopulmonary dysplasia (adjusted incidence rate ratio [AIRR], 1.80) and severe necrotising enterocolitis (AIRR, 1.88) drove the largest increase in neonatal hospital days. By contrast, neonatal brain injury was linked to the smallest rise (AIRR, 1.46; P < .001 for all).

IN PRACTICE:

"This information may assist discussions with families around the time of neonatal discharge, assist with the development and provision of services for these children, and provide a baseline from which to investigate interventions to reduce hospitalization," the authors wrote.

SOURCE:

This study was led by Tim J. van Hasselt, PhD, Department of Population Health Sciences, University of Leicester, Leicester, England. It was published online on September 03, 2025, in JAMA Network Open.

LIMITATIONS:

This study lacked data on the severity of morbidities. Associations were examined at a population level; however, certain unmeasured confounders might still have remained unaccounted for.

DISCLOSURES:

This study received funding through the Advanced Fellowship and Doctoral Research Fellowship from the National Institute for Health and Care Research (NIHR). Some authors reported receiving grants from the NIHR and other institutes.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.