OBJECTIVES: About 5-12% of all pregnancies in western countries result in preterm birth. Preterm born infants may be at increased risk of adverse outcomes. This study compared hospitalization and medication use in the first year of life between preterm and full term born infants. METHODS: Data for this study were obtained from linking the PHARMO database network (including detailed information on drug dispensing and hospitalization histories) with The Netherlands Perinatal Registry (including perinatal medical case records). From this linked cohort, all preterm born infants (gestational age <37 weeks) between 2004-2007 were randomly matched to 4 full term born infants on gender, month and year of birth. All infants were followed from birth until end of data collection in PHARMO or their first birthday, whichever occurred first.  During follow-up, hospitalization and medication use was assessed. Cox proportional hazard regression models were used to estimate the relative risk of hospitalization/medication use among preterms compared to full terms. Population attributable risk percentages (PAR%) were calculated to estimate the proportion of hospitalization/medication use attributable to prematurity. RESULTS: Among the 71,607 singletons born between 2004-2007, 4,277 (6%) were born preterm of which 90% were hospitalized at birth, compared to 55% of the full terms. Premature infants were twice more likely to be re-hospitalized (RR 2.0; 95%CI 1.9-2.2), specifically for respiratory related diseases. Prematurity accounted for 6% of respiratory re-admissions. Between the age of 6-12 months, the most frequently used outpatient drugs were antibacterials and drugs for obstructive airway diseases. Premature infants were 50% more likely to receive respiratory medication (RR 1.5; 95%CI 1.4-1.7). Corresponding PAR% was 3%. CONCLUSIONS: In the first year of life, preterm born infants are up to 2.0 times more likely than full term borns to be hospitalized or use medication, especially related to respiratory disease.