Duration of hospital stay and factors associated with prolonged hospital stay in very low birth weight infants surviving to hospital discharge

Abstract

Background: Ongoing care of surviving very low birth weight infants (VLBWI) is associated with increases in medical costs. Thus, knowing their length of hospital stay (LHS) will assist in counselling parents and budgeting for their neonatal care. Objective: To determine the LHS among VLBWI surviving to hospital discharge and factors associated with prolonged LHS. Methods: This was a retrospective descriptive study performed at Chris Hani Baragwanath Academic Hospital, South Africa. Records of VLBWI who survived to hospital discharge between January 2015 and October 2016 were reviewed. Data on maternal and infant characteristics, morbidities and LHS were recorded. Comparison between those with and without prolonged LHS as defined by being discharged beyond 41 weeks of postmenstrual age was performed. Results: Records of 435 VLBWI who survived to hospital discharge were reviewed. Their mean birth weight and gestational age were 1234±192 grams and 30±2 weeks, respectively. The median duration of LHS was 39 days, with a range of 11 to 183 days. The LHS increased proportionally with decreasing gestational age or birth weight. Thirty-four VLBWI (7.82%) had prolonged duration of hospital stay. On multiple logistic regression analysis factors associated with prolonged LHS were gestational age (OR: 2.01; 95% CI 1.6-2.61), chronic lung disease (OR: 9.40; 95% CI 2.53-34.72), and nosocomial infections (OR: 31.86; 95% CI 6.75-150.3). Conclusions: The median LHS stay for the VLBWI was noted to be 5.5 weeks (39 days) and neonates with morbidities, namely chronic lung disease and nosocomial infections are more likely to have prolonged LHS.