Rehospitalisation Risk Factors and Rates in Preterm Babies: A Systematic Review and Meta-Analysis

Objective: To systematically review evidence of risk factors and rates for rehospitalisations within one month of discharge for babies born at <37 weeks gestation. Design: Systematic review and meta-analysis Data Sources: PubMed (including MEDLINE and life science journals), Web of Science and reference lists of included articles. Study Selection: Inclusion criteria were studies published in English or French between 01 January 2000 to 31 March 2019, recruiting from the year 2000 onwards evaluating risk factors for rehospitalisation within one month of discharge in preterm babies. Two reviewers independently selected relevant studies, extracted study details, baseline characteristics and results of risk factor analyses. Results: : Across 14 included studies, five studied babies of <37 weeks gestation, seven studied late preterm babies (34-36 weeks gestation), and two studied very to moderate preterm babies (<34 weeks gestation). Important risk factors were low birth weight, respiratory morbidity, male sex and lower socioeconomic status in <37 week babies, and shorter length of stay among late preterm babies. Pooled rehospitalisation rates were 4.3% (95% CI 1.9-9.7) in <37 week babies and 6.6% (95% CI 3.2-13.4) in late preterm babies. There was high heterogeneity in risk factors included in analyses and studies often lacked clarity on variable measurement and confounder adjustment. Conclusion: We found evidence for clinical and socioeconomic risk factors, high heterogeneity and important limitations. Limitations included a lack of breadth in both the gestational age ranges and risk factors studied, as well as lack of clarity around variable measurement and confounder adjustment