Affiliations: [a] Department of Pediatrics, Division of Neonatology, University of Virginia School of Medicine, Charlottesville, VA, USA
| [b] University of Virginia School of Medicine, Charlottesville, VA, USA
Correspondence:
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Address for correspondence: Brynne A. Sullivan, MD, MSc, University of Virginia, Pediatrics, PO Box 800386, Charlottesville, VA, 22908-0386, USA. Tel.: +1 434 924 5428; E-mail: Bsa4m@virginia.edu.
Abstract: BACKGROUND:Very low birth weight (VLBW) infants must achieve several maturational milestones to be discharged home from the NICU. OBJECTIVE:Describe the timing of maturational milestones in VLBW infants and the impact of clinical variables and milestone achievement on postmenstrual age (PMA) at discharge. METHODS:For VLBW infants without severe lung disease discharged home from a level IV NICU, we assessed PMA at the achievement of thermoregulation, cardiorespiratory stability, feeding, and discharge. RESULTS:In 400 infants (median GA 28.4 weeks), lower birth weight, white race, and having multiple comorbidities of prematurity predicted later discharge PMA. The most common milestone sequence was CPAP discontinuation, caffeine discontinuation, thermoregulation, apnea resolution, and full oral feeds. PMA at apnea resolution and full oral feeds correlated highly with discharge PMA. CONCLUSIONS:In a single-center VLBW cohort, comorbidities of prematurity impacted the timing of NICU discharge through delay in oral feeding and cardiorespiratory stability.
Keywords: Apnea of prematurity, prematurity, very low birth weight
