Laura Edwards1,2, C Michael Cotten1, P Brian Smith1, Ronald Goldberg1, Shampa Saha3, Abhik Das4, Abbot R Laptook5, Barbara J Stoll6, Edward F Bell7, Waldemar A Carlo8, Carl T D'Angio9, Sara B DeMauro10, Pablo J Sanchez11, Seetha Shankaran12, Krisa P Van Meurs13, Betty R Vohr5, Michele C Walsh14, William F Malcolm15. 1. Department of Pediatrics, Duke University, Durham, NC, 27708, USA. 2. WakeMed Health and Hospitals, Raleigh, NC, 27610, USA. 3. Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC, 27709, United States. 4. Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD, 27709, USA. 5. Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI, 02912, USA. 6. Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, 30322, USA. 7. Department of Pediatrics, University of Iowa, Iowa City, IA, 52242, USA. 8. Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA. 9. University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA. 10. Department of Pediatrics, The Children's Hospital of Philadelphia, The University of Pennsylvania, Philadelphia, PA, 19104, USA. 11. Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, 43205, USA. 12. Department of Pediatrics, Wayne State University, Detroit, MI, 48202, USA. 13. Department of Pediatrics, Division of Neonatal and Developmental Medicine, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, CA, 94305, USA. 14. Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, 44106, USA. 15. Department of Pediatrics, Duke University, Durham, NC, 27708, USA. william.malcolm@duke.edu.
Abstract
OBJECTIVES: The objectives describe the frequency that inadequate oral feeding (IOF) is the reason why moderately preterm (MPT) infants remain hospitalized and its association with neonatal morbidities. STUDY DESIGN: Prospective study using the NICHD Neonatal Research Network MPT Registry. Multivariable logistic regression was used to describe associations between IOF and continued hospitalization at 36 weeks postmenstrual age (PMA). RESULT: A total of 6017 MPT infants from 18 centers were included. Three-thousand three-seventy-six (56%) remained hospitalized at 36 weeks PMA, of whom 1262 (37%) remained hospitalized due to IOF. IOF was associated with RDS (OR 2.02, 1.66-2.46), PDA (OR 1.86, 1.37-2.52), sepsis (OR 2.36, 95% 1.48-3.78), NEC (OR 16.14, 7.27-35.90), and BPD (OR 3.65, 2.56-5.21) compared to infants discharged and was associated with medical NEC (OR 2.06, 1.19-3.56) and BPD (OR 0.46, 0.34-0.61) compared to infants remaining hospitalized for an alternative reason. CONCLUSION: IOF is the most common barrier to discharge in MPT infants, especially among those with neonatal morbidities.
OBJECTIVES: The objectives describe the frequency that inadequate oral feeding (IOF) is the reason why moderately preterm (MPT) infants remain hospitalized and its association with neonatal morbidities. STUDY DESIGN: Prospective study using the NICHD Neonatal Research Network MPT Registry. Multivariable logistic regression was used to describe associations between IOF and continued hospitalization at 36 weeks postmenstrual age (PMA). RESULT: A total of 6017 MPT infants from 18 centers were included. Three-thousand three-seventy-six (56%) remained hospitalized at 36 weeks PMA, of whom 1262 (37%) remained hospitalized due to IOF. IOF was associated with RDS (OR 2.02, 1.66-2.46), PDA (OR 1.86, 1.37-2.52), sepsis (OR 2.36, 95% 1.48-3.78), NEC (OR 16.14, 7.27-35.90), and BPD (OR 3.65, 2.56-5.21) compared to infants discharged and was associated with medical NEC (OR 2.06, 1.19-3.56) and BPD (OR 0.46, 0.34-0.61) compared to infants remaining hospitalized for an alternative reason. CONCLUSION: IOF is the most common barrier to discharge in MPT infants, especially among those with neonatal morbidities.
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