8  •  2020  •  Developmental Observer

Objective

Our objective was to determine the impact of an Early Discharge 
with Home Care Tube Feeding program (EDHC) – regular 
discharge on two-years corrected-age (CA) neurodevelopmental 
outcomes for preterm infants born between 25 and 35 
gestational age (GA). Secondary outcome measures were length 
of hospitalization stay, breastfeeding and first year hospital 
readmissions.

Methods

This observational study compared 415 EDHC preterm infants 
from Toulouse University Hospital, born between 2008 and 
2015, and 3186 preterm infants of the EPIPAGE 2 study cohort 
born in all French newborn units in 2011. Neurodevelopmental 
Ages and Stages Questionnaire (ASQ) was used to assess neuro-
developmental outcomes. Length of hospital stay, breastfeeding 
rates at discharge and six-months and hospital readmission rates 
during the first year were compared between the two groups. 
Differences in the two populations characteristics were adjusted 
with multivariate multilevel regression analyses. 

Results

At two-years CA data on ASQ were available for 125 EDHC 
and 2066 EPIPAGE 2 preterm children. EDHC preterm 
singletons had 61% less risk to obtain a total ASQ score below 

threshold of 220 (OR = 0.39 [0.32-0.48], p < 0.001), less risk to 
have communication abilities above threshold (OR=0.42 [0.34-
0.53] p<0.0001), fine motor skills above threshold (OR=0.63 
[0.51-0.78] p<0.0001), problem solving abilities above thresh-
old (0R=0.53 [0.43-0.66] p<0.0001), and personal-social skills 
above threshold (OR=0.64 [0.52-0.78] p<0.0001).

Length of hospital stay was nine days shorter for the EDHC 
preterm infants (p<0,0001). 

EDHC preterm children were more likely to be breastfed at 
final discharge (OR = 3.59 [2.82-4.58], p < 0.001 for singletons 
and OR = 2.25 [1.62-3.14], p < 0.001 for multiples), and 
breastfeeding was more likely to be continued over six months 
among those same children (OR = 1.76 [1.34-2.32], p < 0.001 
for singletons, OR = 3.64 [2.10-6.32], p < 0.001 for multiples).
Finally, EDHC children singletons had less risk to be readmitted 
in hospital during the first year (OR = 0.65 [0.55 to 0.77], p < 
0.001).

Conclusion

The Early Discharge with Home Care Program seems to improve 
neurodevelopmental outcome at two years of age, length of 
hospital stay and breastfeeding among preterm infants. It seems 
also to protect from hospital readmission during the first year. 
Home care should be promoted in newborn intensive care policies.

Early Discharge with Home Care Tube Feeding Program 
Benefits on Two Years Corrected Age Neurodevelopmental 
Outcomes, Breastfeeding and First Year Hospital Readmissions 
for Premature Infants
Losbar J1, Arnaud C2, Glorious I1, Lescure S1, Casper C1, Montjaux N1

1 NICU, Children's Hospital, Toulouse University Hospital, France
2 UMR 1017, INSERM, Toulouse University Hospital France

The WHO has designated 2020 the International Year of the Nurse and the Midwife. Nurses and midwives play a vital role in providing health 
and caring for mothers and babies . We would like to hear your stories and how NIDCAP has enhanced the role of nurses and midwives.

DOI: 10.14434/do.v13i1.29083