Term admissions to neonatal intensive care unit : a Maltese observational study

Abstract

Objective: This study aimed to identify the number of term infants admitted to the Maltese Neonatal and Paediatric Intensive Care Unit (NPICU) between January and June 2016, as well as factors contributing to their admission. Methods: All term infants (37+ weeks gestation) born in January-June 2016, transferred from Central Delivery Suite or Obstetric Wards to NPICU were identified. Patient registers, electronic case summaries, and the National Obstetric Information System (NOIS) database were used, with approval from the Data Protection Office, to collect data for a retrospective case control study. Results: Of the term infants born in these 6 months, 5.2% (101) were admitted to NPICU resulting in 42.6% of all admissions. The mean gestational age was 39 weeks (95% CI 38.8, 39.3) and mean birth weight was 3.3kg (95% CI 3.2, 3.4). More than half had been born by elective and emergency Caesarean section (26% and 27% respectively). Commonest reason for admission was respiratory distress (37%). Others included non-bilious vomiting (20%), congenital abnormalities (13%), hyperbilirubinaemia (8%), and infection (4%). Statistically significant factors associated with admission were operative delivery, threatened abortion and maternal infection during pregnancy, maternal insulin dependent diabetes mellitus, and low Apgar scores. Conclusion: The significant contributing factors should be targeted and further evaluation over a longer time-frame with an interdisciplinary team carried out in an effort to reduce rate of admissions and improve quality of care.