Epidemiology of Surgical Procedures, Anesthesia and Imaging Studies by Gestational Age during the First Year of Life in Medicaid-Insured Infants.

Objectives To evaluate the rate of surgical procedures, anesthetic use and imaging studies by prematurity status for the first year of life we analyzed data for Texas Medicaid-insured newborns. Study design We developed a retrospective population-based live birth cohort of newborn infants insured by Texas Medicaid in 2010-2014 with 4 sub-cohorts: extremely premature, very premature, moderate/late premature, and term. Results In 1,102,958 infants, surgical procedures per 100 infants were 135.9 for EP, 35.4 for VP, 15.5 for MLP and 6.5 for T. Anesthetic use was 62.0 for EP, 20.8 for VP, 11.1 for MLP and 5.6 for the T sub-cohort. The most common procedures in the EP were neurosurgery, intubations and procedures that facilitated caloric intake (gastrostomy tubes and fundoplications). The annual rates for the first year of life for chest x-ray (CXR) ranged from 15.0 per year for the EP cohort to 0.6 for term infants and for MRI from 0.3 to 0.01. MRI was the most common imaging study with anesthesia support in all maturity levels. MRIs were done in EP without anesthesia in over 90% and in term infants in 57.2%. Conclusion Surgical procedures, anesthetic use, and imaging studies in infants are common and more frequent with higher a degree of prematurity while the use of anesthesia is lower in more premature newborns. These findings can provide direction for outcome studies of surgery and anesthesia exposure.