Neonatal intensive care admission for term neonates and subsequent childhood mortality: a retrospective linkage study
Abstract Background Neonatal 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. Methods A single-center case–control retrospective study betw...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-02-01
|
| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-023-02744-7 |
| _version_ | 1828035200153550848 |
|---|---|
| author | Shahar Talisman Joshua Guedalia Rivka Farkash Tehila Avitan Naama Srebnik Yair Kasirer Michael S. Schimmel Donia Ghanem Ron Unger Sorina Grisaru Granovsky |
| author_facet | Shahar Talisman Joshua Guedalia Rivka Farkash Tehila Avitan Naama Srebnik Yair Kasirer Michael S. Schimmel Donia Ghanem Ron Unger Sorina Grisaru Granovsky |
| author_sort | Shahar Talisman |
| collection | DOAJ |
| description | Abstract Background Neonatal 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. Methods A 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. Results During 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]. Conclusions NICU 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. |
| first_indexed | 2024-04-10T15:44:28Z |
| format | Article |
| id | doaj.art-acc4ad3dcbd04981931e5846f341e058 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-04-10T15:44:28Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-acc4ad3dcbd04981931e5846f341e0582023-02-12T12:14:18ZengBMCBMC Medicine1741-70152023-02-0121111110.1186/s12916-023-02744-7Neonatal intensive care admission for term neonates and subsequent childhood mortality: a retrospective linkage studyShahar Talisman0Joshua Guedalia1Rivka Farkash2Tehila Avitan3Naama Srebnik4Yair Kasirer5Michael S. Schimmel6Donia Ghanem7Ron Unger8Sorina Grisaru Granovsky9Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University-Hadassah School of MedicineThe Mina and Everard Goodman Faculty of Life Sciences, Bar Ilan UniversityDepartment of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University-Hadassah School of MedicineDepartment of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University-Hadassah School of MedicineDepartment of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University-Hadassah School of MedicineDepartment of Pediatrics, Shaare Zedek Medical Center, Affiliated with the Hebrew University-Hadassah School of MedicineDepartment of Pediatrics, Shaare Zedek Medical Center, Affiliated with the Hebrew University-Hadassah School of MedicineDepartment of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University-Hadassah School of MedicineThe Mina and Everard Goodman Faculty of Life Sciences, Bar Ilan UniversityDepartment of Obstetrics & Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University-Hadassah School of MedicineAbstract Background Neonatal 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. Methods A 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. Results During 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]. Conclusions NICU 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.https://doi.org/10.1186/s12916-023-02744-7Neonatal intensive care unit (NICU)Term neonateLong-term mortalityNICU admission diagnosis |
| spellingShingle | Shahar Talisman Joshua Guedalia Rivka Farkash Tehila Avitan Naama Srebnik Yair Kasirer Michael S. Schimmel Donia Ghanem Ron Unger Sorina Grisaru Granovsky Neonatal intensive care admission for term neonates and subsequent childhood mortality: a retrospective linkage study BMC Medicine Neonatal intensive care unit (NICU) Term neonate Long-term mortality NICU admission diagnosis |
| title | Neonatal intensive care admission for term neonates and subsequent childhood mortality: a retrospective linkage study |
| title_full | Neonatal intensive care admission for term neonates and subsequent childhood mortality: a retrospective linkage study |
| title_fullStr | Neonatal intensive care admission for term neonates and subsequent childhood mortality: a retrospective linkage study |
| title_full_unstemmed | Neonatal intensive care admission for term neonates and subsequent childhood mortality: a retrospective linkage study |
| title_short | Neonatal intensive care admission for term neonates and subsequent childhood mortality: a retrospective linkage study |
| title_sort | neonatal intensive care admission for term neonates and subsequent childhood mortality a retrospective linkage study |
| topic | Neonatal intensive care unit (NICU) Term neonate Long-term mortality NICU admission diagnosis |
| url | https://doi.org/10.1186/s12916-023-02744-7 |
| work_keys_str_mv | AT shahartalisman neonatalintensivecareadmissionfortermneonatesandsubsequentchildhoodmortalityaretrospectivelinkagestudy AT joshuaguedalia neonatalintensivecareadmissionfortermneonatesandsubsequentchildhoodmortalityaretrospectivelinkagestudy AT rivkafarkash neonatalintensivecareadmissionfortermneonatesandsubsequentchildhoodmortalityaretrospectivelinkagestudy AT tehilaavitan neonatalintensivecareadmissionfortermneonatesandsubsequentchildhoodmortalityaretrospectivelinkagestudy AT naamasrebnik neonatalintensivecareadmissionfortermneonatesandsubsequentchildhoodmortalityaretrospectivelinkagestudy AT yairkasirer neonatalintensivecareadmissionfortermneonatesandsubsequentchildhoodmortalityaretrospectivelinkagestudy AT michaelsschimmel neonatalintensivecareadmissionfortermneonatesandsubsequentchildhoodmortalityaretrospectivelinkagestudy AT doniaghanem neonatalintensivecareadmissionfortermneonatesandsubsequentchildhoodmortalityaretrospectivelinkagestudy AT ronunger neonatalintensivecareadmissionfortermneonatesandsubsequentchildhoodmortalityaretrospectivelinkagestudy AT sorinagrisarugranovsky neonatalintensivecareadmissionfortermneonatesandsubsequentchildhoodmortalityaretrospectivelinkagestudy |