TOP 50 - Characterizing Unanticipated Term Neonatal NICU Admissions within a Transitional Care Nursery Model

Publication Number: 4754.TOP 50

Talia Segal, NewYork-Presbyterian Komansky Children’s Hospital, New York, NY, United States; Divya Ganugapati, NewYork-Presbyterian Komansky Children’s Hospital, New York, NY, United States; Divya Mandalaywala, Weill Cornell Medicine, New York, NY, United States; Jayasree Nair, Weill Cornell Medicine, New York, NY, United States

Background: Recent literature has shown an increase in admission rates of term neonates to the neonatal intensive care unit (NICU). One study found admission rates range from 2.9-11.2%, with respiratory distress, hypoglycemia and jaundice being leading causes. Newborn care practices vary among hospitals with some including a transitional care nursery to decrease the burden of NICU admissions in lower-risk infants. Admissions to the NICU come with increased risk for infant morbidity and mortality, emotional and financial burden to families, and prolonged hospital stay and healthcare costs. Furthermore, unanticipated term NICU admissions are considered a marker for perinatal care quality. Despite evidence of increased admission rates, there remains key gaps in current literature regarding factors that lead to unanticipated term NICU admission and subsequent short-term neonatal outcomes.

Objective: The primary objective of this study is to determine the incidence of and predominant reasons for unanticipated NICU admission among term neonates in a tertiary care center with a transitional care nursery. Secondary objectives are to further identify maternal and neonatal risk factors associated with term neonate admissions, and to recognize their effect on neonatal morbidities and length of stay.

Design/Methods: This study is a retrospective chart review that includes liveborn infants ≥ 37 weeks gestation admitted to a level IV NICU from January 1, 2024 to June 30, 2024. Patients with identified need for automatic NICU admission, such as birth weight < 1900g, prenatally diagnosed congenital anomalies, and risk for neonatal abstinence syndrome were excluded. Data collected from electronic medical records includes demographics, maternal prenatal history, delivery room course, admission diagnosis, neonatal interventions, length of stay, and disposition.

​​Preliminary data shows of 3996 term hospital deliveries during the six-month study period, 204 term infants were admitted to the NICU; of these, only 169 infants met inclusion criteria, representing an unanticipated NICU admission rate of 4.2%. Further data analysis will be completed over the next two months by a biostatistician using R 4.3.1 statistical software. We will include descriptive statistics of our cohort, comparative analysis using chi-square or Fisher’s exact tests, and outcome analysis using logistic regression models.