Global Variation in Length of Hospital Stay Among Preterm Neonates: A Scoping Review
Year: 2026
Type: preprint
Abstract: Preterm birth is a major cause of neonatal mortality, childhood morbidity, neurodevelopmental impairment, and healthcare-resource use. Preterm neonates often require prolonged hospitalization because of physiological immaturity, feeding difficulties, respiratory problems, infections, and other complications. However, the duration of hospitalization varies substantially between infants, neonatal units, countries, and healthcare systems. This variation may reflect gestational age, birth weight, clinical complications, treatment practices, discharge criteria, parental preparedness, availability of home-care services, and local healthcare resources. This scoping review aims to map global evidence on the length of hospital stay among liveborn preterm neonates born before 34 completed weeks of gestation. The primary research question is: What is the global variation in hospital length of stay among preterm neonates born before 34 weeks? The review will examine differences across countries, geographical regions, World Bank income categories, gestational-age groups, birth-weight groups, and healthcare settings. The primary outcome will be the duration of the initial birth hospitalization until first discharge home. The review will document how length of stay is defined and reported, including its starting and ending points, the handling of transfers and deaths, and whether results are presented as means, medians, ranges, postmenstrual age at discharge, or time-to-discharge estimates. Eligible evidence will include cohort, cross-sectional, case-control, randomized, and non-randomized studies published from 2010 onward when relevant length-of-stay data are available. PubMed, Embase, Scopus, and CENTRAL will be searched, supplemented by citation searching and relevant grey literature. Two reviewers will independently screen records, and data extraction will capture study methods, geographical setting, neonatal characteristics, clinical complications, treatments, and reported length-of-stay outcomes. The findings will be synthesized descriptively using tables, charts, geographical maps, and narrative summaries. No meta-analysis or causal inference is planned because substantial clinical and methodological heterogeneity is expected. The anticipated outcomes are a comprehensive map of available evidence, identification of global and regional variation, clarification of inconsistent length-of-stay definitions, description of factors associated with hospitalization duration, and identification of geographical and methodological evidence gaps. These findings may support more standardized reporting, meaningful international comparisons, future research, healthcare planning, and neonatal-resource allocation.
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7202201365