Follow-up status of 7 465 preterm infants after discharge in Shenzhen from 2017 to 2023

Objective To investigate the current situation and problems by following up premature infants, so as to improve the system management rate of them after discharge.

Methods Based on data analysis of all follow-up infants ≤ 2 years at high-risk clinic in Shenzhen Maternity & Child Healthcare (MCH) hospital from August 2017 to July 2023, we tried to investigate the composition of premature infants in the high-risk clinic in tertiary MCH hospital and follow up premature infants with different gestational age within 24 months old. Logistic regression analysis was used to analyze the factors associated with follow-up rate of premature infants.

Results Among the 7 465 premature infants, 451 were extremely premature (6.04%), 1 394 were very premature (18.67%), 1 464 were moderately preterm (19.61%), and 4 156 were late premature (55.68%). Premature infants with good follow-up compliance were those with small and medium gestational age and low birth weight. Among them, the follow-up rate of extremely premature infants < 28 weeks was the highest, with the follow-up rates at corrected age of 6, 12, 18, and 24 months (84.92%, 62.31%, 44.79%, and 48.12%, respectively). The follow-up rate of premature infants after corrected age of 6 months decreased significantly. The follow-up rates of extremely premature infants, very premature infants, moderately preterm infants and late preterm infants at 12 months and 24 months of corrected age were 62.31%, 47.27%, 45.49%, and 45.67%, and 48.12%, 33.64%, 16.26% and 15.16% respectively, and the differences were statistically significant (χ² = 46.746, χ² = 442.225, all P < 0.001). Logistic regression analysis showed that follow-up rates of boys, small gestational age, low birth weight, mothers with high education background, first birth, twins or multiple fetuses were higher.

Conclusion Perception to follow-up after discharge are not identical among parents of preterm infants. They pay more attention to the early follow-up (≤ 6 months), and ignore 12 months and subsequent follow ups. Health education of the significance of follow-up after discharge should be strengthened, three-tie network management based on the extent of disease should be implemented concurrently, so as to improve the system management rate of preterm infants after discharge.