Aim To asses the proportion of ex-premature babies who go on to be admitted to PICU (Paediatric Intensive Care) in their first 2 years of life, and the way in which their gestation modifies treatment requirements.
Method PICANet (National PICU database) admission data were retrieved for all PICU admissions in England and Wales who were under 2 years old between 01/01/2007 and 31/12/2010 with gestation less than 36 weeks. 2007–2008 gestation specific live-birth and neonatal mortality rates for England and Wales have been published by the Office of National Statistics. Data was analysed in Microsoft Excel,with Chi-squared and Kruskal–Wallis tests, with statistical significance at 5% level.
Result Birth gestation was recorded for 70% (11559/16680) of the studied PICU admissions.
3.8% of babies born in England and Wales in 2007–2008 were born at less than 36 weeks gestation. 3.2% of these babies went on to be admitted to PICU before their second birthday, comprising 12.4% of all PICU admissions in the under 2s.
Late pre-term babies account for a higher number of PICU admissions overall. (See Figure 1). However, the admission rate, when expressed as the percentage of those alive at day 28, is higher among extreme pre-term babies. (See Figure 2)
Statistically significant differences between gestational cohorts were seen in lthe median length of stay (see Figure 3) and median duration of ventilation. No difference in PICU associated mortality was seen.
Conclusion A higher percentage of extreme preterm babies than late preterm babies are admitted to PICU in their first 2 years of life. They require longer stays and longer durations of ventilation.
The rising preterm birth rate coupled with increasing survival of extreme preterm babies will have a significant impact on PICU demand.