Risk Factors Identified for Post NICU-Discharge Mortality
(HealthDay News) – Premature babies with extremely low birth weight (ELBW) are at increased risk of dying following discharge from the neonatal intensive care unit (NICU) if they are African-American, lack health insurance, or had a long stay in the NICU, according to a study published online Feb. 9 in The Journal of Pediatrics.
Lilia C. De Jesus, MD, from Wayne State University in Detroit, and colleagues conducted a retrospective analysis of ELBW (<1,000g) and <27-weeks-gestational-age infants born from January 2000–June 2007 in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network sites. Post-NICU discharge mortality (P-NDM) was defined as infants who died between NICU discharge and the 18- to 22-month follow-up visit (corrected age). Six significant predictors were incorporated into a prediction model, which was then validated.
The researchers found that 5,364 infants survived to NICU discharge. Over the study period, 557 infants (10%) were lost to follow-up and 107 infants died following NICU discharge, representing a P-NDM rate of 22.3 per 1,000 ELBW infants. In the prediction model, there was a significantly increased risk associated with African-American race, unknown maternal health insurance, and a hospital stay ≥120 days. Maternal exposure to intrapartum antibiotics was associated with a decreased risk of P-NDM.
"We identified African-American race, unknown medical insurance, and prolonged NICU stay as risk factors associated with P-NDM among ELBW infants," the authors write.