Neonatal intensive care admission for term neonates and subsequent childhood mortality: a retrospective linkage study

BMC Medicine

Research Article

Tehila Avitan¹  Donia Ghanem¹  Shahar Talisman¹  Rivka Farkash¹  Naama Srebnik¹  Sorina Grisaru Granovsky¹  Yair Kasirer²  Michael S. Schimmel²  Ron Unger³  Joshua Guedalia³ 

[1] Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University-Hadassah School of Medicine, Jerusalem, Israel;Department of Pediatrics, Shaare Zedek Medical Center, Affiliated with the Hebrew University-Hadassah School of Medicine, Jerusalem, Israel;The Mina and Everard Goodman Faculty of Life Sciences, Bar Ilan University, Ramat-Gan, Israel;

关键词: Neonatal intensive care unit (NICU);    Term neonate;    Long-term mortality;    NICU admission diagnosis;   

DOI  :  10.1186/s12916-023-02744-7

 received in 2022-05-25, accepted in 2023-01-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundNeonatal intensive care unit (NICU) admission among term neonates is a rare event. The aim of this study was to study the association of the NICU admission of term neonates on the risk of long-term childhood mortality.MethodsA single-center case–control retrospective study between 2005 and 2019, including all in-hospital ≥ 37 weeks’ gestation singleton live-born neonates. The center perinatal database was linked with the birth and death certificate registries of the Israeli Ministry of Internal Affairs. The primary aim of the study was to study the association between NICU admission and childhood mortality throughout a 15-year follow-up period.ResultsDuring the study period, 206,509 births were registered; 192,527 (93.22%) term neonates were included in the study; 5292 (2.75%) were admitted to NICU. Throughout the follow-up period, the mortality risk for term neonates admitted to the NICU remained elevated; hazard ratio (HR), 19.72 [14.66, 26.53], (p < 0.001). For all term neonates, the mortality rate was 0.16% (n = 311); 47.9% (n = 149) of those had records of a NICU admission. The mortality rate by time points (ratio1:10,0000 births) related to the age at death during the follow-up period was as follows: 29, up to 7 days; 20, 7–28 days; 37, 28 days to 6 months; 21, 6 months to 1 year; 19, 1–2 years; 9, 2–3 years; 10, 3–4 years; and 27, 4 years and more. Following the exclusion of congenital malformations and chromosomal abnormalities, NICU admission remained the most significant risk factor associated with mortality of the study population, HRs, 364.4 [145.3; 913.3] for mortality in the first 7 days of life; 19.6 [12.1; 32.0] for mortality from 28 days through 6 months of life and remained markedly elevated after age 4 years; HR, 7.1 [3.0; 17.0]. The mortality risk related to the NICU admission event, adjusted for admission diagnoses remained significant; HR = 8.21 [5.43; 12.4].ConclusionsNICU admission for term neonates is a pondering event for the risk of long-term childhood mortality. This group of term neonates may benefit from focused health care.

【 授权许可】

CC BY   
© The Author(s) 2023

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