Pediatric care for preterm infants after NICU discharge: High number of office visits and prescription medications

Objective: To determine the frequency and risk factors for clinic and pharmacy use in preterm infants during the first year after neonatal intensive care unit (NICU) discharge. Study Design: We analyzed clinic visits and prescriptions in a cohort of 23 to 32 weeks infants. We constructed multivariable regression models to determine risk factors for high use. Result: The 892 preterm infants experienced 18346 pediatric visits (mean 20 visits per infant per year) and filled 2100 prescriptions (mean 5.5 prescriptions per year among infants taking medications). Most visits were non-well child care visits to pediatric primary care providers. Prematurity and bronchopulmonary dysplasia (BPD) are important risk factors: infants at 23 to 26 weeks gestation or infants with BPD had an average 29 visits per year and 9 prescriptions per year among infants taking medication. However, half of the highest using infants were relatively healthy infants at 27 to 32 weeks gestation who escaped BPD, NEC or grade 3 to 4 intraventricular hemorrhage. Conclusion: Premature infants had frequent pediatric visits and prescription medications. Extreme prematurity and neonatal morbidities are important risk factors; however, half of the highest using infants are moderately preterm without neonatal morbidities.