The use of prenatal steroids and exogenous surfactant have resulted in increased survival of ELBW infants. Earlier D/C home results in potentially high DR and high rehosp postdischarge. This multicenter study of ELBW evaluated multiple health outcomes & DR variables from D/C through 18+4 mo corrected age. Here we focus on DR utilization; occupat/physical therapy(OT/PT); early intervention (E.I.); speech and language (S&L); and rehosp in 1,143 of 1,527 (78%) ELBW survivors. We hypothesized that most ELBW require DR and rehosp and that increased DR needs and increased rehosp are directly correlated with decreased G.A. and decreased BW and NICU morbidity.

Results of DR utilization; rehosp; post conceptional age (PCA) at D/C median n of wks: Table By 18+4 mo, 21%-46% of ELBW consumed DR and 58% required rehosp (1509 rehosp range 1-21) Logistic regression analysis showed significant associations between decreased BW(p<.009) male gender (p<.004), IVH Gr 3-4 (p<.004), O2 at 36 wks PCA(p<.0008), use of post-natal steroids (p<.0001) and use of DR. White males were at highest risk, white females were at lowest risk for rehosp. For females decreased BW (p<.020), post-natal steroids (p<.009) were sig associated with risk of rehosp. For males decreased BW (p<.002), decreased GA (p<.02), and IVH Gr 3-4 (p<.03) were significantly associated with risk of rehosp. Caretaker education was neither a risk indicator for increased DR needs nor increased rehosp. Summary: Males continue to be at higher risk post D/C Increased survival of ELBW infants has resulted in new challenges for health care providers for post discharge management both to facilitate DR use when indicated and prevent rehospitalization.

Table 1 No caption available.
Full size table