Bénéfices à 2 ans d'une sortie précoce en hospitalisation à domicile pour les nouveau-nés prématurés en cours d'apprentissage des tétées : comparaison avec la cohorte EPIPAGE 2

Abstract : Objectives: Our main goal was to evaluate, compared with usual management, the effect of early discharge for tube-fed preterm infants on their neurodevelopment at 2 years corrected age, assessed by the ASQ-3. Our secondary goals were to evaluate the effect of early discharge on length of hospitalization, breastfeeding and the rate of readmissions at 1 year. Methods: This observational study compared the early discharge group (EDG) with 415 children admitted in the University Hospital of Toulouse between 2008 and 2015 to support learning feedings and the comparison group with 3186 children from the national cohort EPIPAGE 2 who went home directly according to conventional care. All children were born between 25 and 35 weeks of gestational age. The neurodevelopmental evaluation was possible for 125 infants in the EDG and 2066 infants in the EPIPAGE 2 group. Bivariate and multivariate multilevel analyses were conducted. Results: At two years corrected age, the infants in the EDG had 61% less risk of having a total ASQ less than or equal to 220 (OR = 0.39 [0.32-0.48], p < 0.001) and between 31 and 80% less likely to have pathological scores in four out of five domains, compared to children in the EPIPAGE 2 group. Length of hospitalization was 9 days shorter (p < 0.001). They were more frequently breastfed at the final discharge from hospital (OR = 3.59 [2.82-4.58], p < 0.001 for singletons and OR = 2.25 [1.62-3.14], p < 0.001 for multiples) and more frequently breastfed for more than six months (OR = 1.76 [1.34-2.32], p < 0.001 for singletons, OR = 3.64 [2.10-6.32], p < 0.001 for multiples). Finally, singletons of EDG were less frequently readmitted in the first year (OR = 0.65 [0.55 to 0.77], p < 0.001). Conclusion: Preterm infants learning feedings in the early discharge program have a better neurodevelopment at 2 years corrected age, compared with the EPIPAGE 2 cohort. The length of hospitalization is reduced and infants receive more frequently breast milk at six months. Safety of this program is also confirmed by our study.
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Jennifer-Laurence Losbar. Bénéfices à 2 ans d'une sortie précoce en hospitalisation à domicile pour les nouveau-nés prématurés en cours d'apprentissage des tétées : comparaison avec la cohorte EPIPAGE 2. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02047872⟩

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