Impact of Specialized Nursery Care for Late Preterm Infants on NICU Admission Rate and Length of Stay

Laura Hunt; Gene Hallford; Candace Robledo; Edgardo Szyld; Clara Song

doi:10.1055/s-0035-1552938

American Journal of Perinatology, Table of Contents

Am J Perinatol 2015; 32(13): 1198-1204
DOI: 10.1055/s-0035-1552938

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Impact of Specialized Nursery Care for Late Preterm Infants on NICU Admission Rate and Length of Stay

Laura Hunt

¹Department of Pediatrics, Neonatal-Perinatal Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

²Department of Neonatology, Cook Children's Hospital, Fort Worth, Texas, United States

,

Gene Hallford

³Department of Pediatrics, Genetics Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

,

Candace Robledo

⁴School of Public Health, University of Texas Health Science Center, Fort Worth, Texas

,

Edgardo Szyld

⁵Department of Preventive Medicine, Icahn School of Medicine at Mt. Sinai, New York, New York

⁶Department of Mastery in Clinical Research, Universidad Abierta Interamericana, Buenos Aires, Argentina

,

Clara Song

¹Department of Pediatrics, Neonatal-Perinatal Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

› Author Affiliations

Abstract

Objective To compare neonatal intensive care unit (NICU) admission rates and length of stay (LOS) of late preterm infants (LPIs) born before and after opening a specialized care nursery (SCN) at our academic, pediatric tertiary care center with ∼4,500 total deliveries annually.

Study Design Retrospective chart review of inborn LPIs (35^0/7–36^6/7 weeks) who were asymptomatic or minimally symptomatic at birth and delivered 7 months before the opening of the SCN (pre-SCN) or 7 months subsequently (post-SCN). Infants were excluded for major congenital anomalies or other conditions requiring immediate NICU admission. The pre-SCN options for care were standard couplet care or NICU. The post-SCN options for care were standard couplet care, SCN, or NICU.

Results Pre-SCN (n = 109), 73 (67%) infants received standard couplet care, while 36 (33%) infants were ever admitted/transferred to the NICU. Post-SCN (n = 112), 59 (53%) infants received standard couplet care, while 20 (18%) were ever admitted/transferred to the NICU. A total of 33 (29%) infants were admitted/transferred to the SCN and avoided a NICU stay. Median LOS for all infants was 3 days.

Conclusion The frequency of LPIs admitted/transferred to the NICU decreased by ∼50% after the opening of the SCN. LOS did not differ by birth cohort, but did differ significantly by location of care (standard couplet care < SCN < NICU).

Keywords

late preterm - NICU admission - Length of Stay

Full Text

References

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