Moderately preterm infants (30-34 weeks) account for a large proportion of admissions and bed-days in neonatal units. A large study (2,388 infants) of the postmenstrual age (PMA) at hospital discharge and its relationship to perinatal risk factors and to organisation of care was carried out in Sweden. The researchers found that average PMA at discharge was 36.9 weeks. High (35 years) maternal age, multiple birth, small for gestational age, respiratory distress syndrome, infection, hypoglycaemia and hyperbilirubinaemia were significantly associated with higher PMA at discharge, but could only explain 13 per cent of the differences. Mean PMA at discharge differed by up to two weeks between hospitals. Infants treated at units without fixed discharge criteria had 4.7 days lower PMA at discharge and infants receiving domiciliary care had 9.8 days lower PMA at discharge. Breastfed infants also had lower PMA at discharge (mean 2.7 days lower) than those not breastfed, partly explained by lower morbidity in the breastfed infants and the researchers recommend that supporting the establishment of successful breast feeding in preterm infants should therefore be given high priority in neonatal care.
