Determinants of Extended Neonatal Intensive Care Unit Stay

Document Type : Original Article

Authors

Neonatal Intensive Care Unit, Hermina Hospital Sukabumi, West Java, Indonesia

Abstract

Background: Prolonged hospitalization in the Neonatal Intensive Care Unit (NICU) escalates healthcare costs and potentially exposes neonates to further complications. This study aimed to identify the significant predictors influencing the length of stay (LOS) in the NICU at Hermina Hospital, Sukabumi, with the potential to facilitate efficient resource optimization and improve the future of neonatal care.
Methods: Employing a retrospective cohort design, we reviewed the medical records of all neonatal admissions from July 1, 2022, to July 1, 2023. Length of stay was evaluated against several factors: gender, birth weight, delivery method, maternal pregnancy status, pregnancy comorbidities, place of birth, and Apgar score. This study computed the descriptive and inferential statistics using SPSS version 29, with linear regression models aiding in bivariate and multivariate analyses.
Results: Among the 156 samples, birth weight and Apgar score emerged as significantly associated with LOS (p-values 0.003 and 0.015, respectively), whereas the other predictors did not reveal a significant association. T-test outcomes suggested a partial impact on birth weight and Apgar score (t-values surpassing the critical t-value, with respective p-values < 0.001 and 0.014). Multiple regression analysis further indicated that all predictors collectively explained 19.3% of the LOS variation.
Conclusion: Our findings underscore the significant contribution of birth weight and Apgar score to prolonged NICU stays. They provide valuable insights into the factors influencing NICU length of stay and the potential for improving neonatal outcomes through adequate neonatal resuscitation. Moreover, the study emphasizes the urgent need for targeted programs to reduce preterm delivery and intrauterine growth retardation, inspiring action and change in the field of neonatal care.
 

Keywords

References

  1. Tedesse A, Negussie YM, Aychiluhm SB. Neonatal mortality and its associated factors among neonates admitted at public hospitals, pastoral region, Ethiopia: A health facility based study. Plos One. 2021;16(3):e0242481.
  2. World Health Organization. WHO recommendations on newborn health: guidelines approved by the WHO Guidelines Review Committee. Geneva: World Health Organization; 2017.
  3. Said, A. Berita Resmi Statistik. Jakarta: Badan Pusat Statistik. 2023.
  4. Fu M, Song W, Yu G, Yu Y, Yang Q. Risk factors for length of NICU stay of newborns: A systematic review. Front Pediatr. 2023;11:1121406.
  5. Cheah I. Economic assessment of neonatal intensive care. Translational Pediatrics. 2019;8(3):246-256.
  6. Wang K, Hussain W, Birge JR, Schreiber MD, Adelman D. A High-fidelity model to predict length of stay in the neonatal intensive care unit. INFORMS J Comput. 2022;34(1):183–95.
  7. Xie F, Shu Q, Chen ZY, Li J. Length of stay and influencing factors of NICU in the Western Hunan, an underdeveloped area of China: A 9-year retrospective study. J Int Med Res. 2022;50(6):3000605221100753.
  8. Mathew, S. J., Mathankumar, S., & Vaishnodevi, S. Portable Neonatal Intensive Care Unit. Int J Innov Res Sci Eng Technol. 2015;4(5):3699-3703.
  9. PT, Pepler, Uys DW and Nel DG. Predicting mortality and length-of-stay for neonatal admissions to private hospital neonatal intensive care units: A Southern African retrospective study. African Health Sciences. 2012;12(2):166-173.
  10. Fenny AP, Otieku E, Labi KA, Asante FA, Enemark U. Costs and extra length of stay because of neonatal bloodstream infection at a teaching hospital in Ghana. Pharmacoecon Open. 2021;5(1):111-120.
  11. Sahiledengle B, Tekalegn Y, Zenbaba D, Woldeyohannes D, Teferu Z. Which factors predict hospital length-of-stay for children admitted to the neonatal intensive care unit and pediatric ward? A hospital-based prospective study. Glob Pediatr Health. 2020;7:2333794X20968715.
  12. Haifa A. Risk factors associated with preterm birth: a retrospective study in Mukalla Maternity and Childhood Hospital, Hadhramout Coast/Yemen. Sudan J Paediatr. 2020;20(2):99-110.
  13. Nidhi K. Maternal stress in neonatal intensive care unit very often overlooked by health professionals. Ind Psychiatry J. 2020; 29(1):130-133.
  14. Nugraha GB, Anggraini NW. Mode of Delivery and Neonatal Outcomes in Preterm Pregnancy. J. Obstet. Gynecol. 2023;11(2):70-73.
  15. Tong G, Guo G. The life-course association of birth-weight genes with self-rated health. Biodemography Soc Biol. 2020;65(3):268-286.
  16. Afrasiabi N, Mohagheghi P, Kalani M, Mohades G, Farahani Z. The effect of high risk pregnancy on duration of neonatal stay in neonatal intensive care unit. Iran J Pediatr. 2014;24(4):423-428.
  17. Chavan S, Malwade SD, Kumari S, Garud BP, Agarkhedkar S. Incidence, Clinical Features, and Outcomes of Transient Tachypnea of the Newborn at a Tertiatry Care Center in Western India. Cureus. 2022;14(4):e23939.
  18. Haksari EL, Hakimi M, Ismail D. Respiratory distress in small for gestational age infants based on local newborn curve prior to hospital discharge. Front Pediatr. 2022;10:986695.
Iranian Journal of Neonatology
Volume 15, Issue 4
October 2024
Pages 43-48

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