Clinical outcomes and cost of the moderately preterm infant

The purpose of this study is to define the incidence of admission and morbidities and the economic impact of moderately preterm infants in the neonatal intensive care unit (NICU).

A retrospective descriptive study.

All infants born between 32 to 34 weeks' gestational age (GA) (n=4932) followed by ParadigmHealth, a care management company, from January 2001 through June 2004 were evaluated. Infants with major congenital anomalies were excluded. This sample represented 453 NICUs in 24 states in the United States.

Retrospective data analysis. Infants born between 32 and 34 weeks' GA were studied (n=4932). This subset of patients in the NICU was compared to the entire population in the database (n=19,923) for incidence and cost comparison. Infants were followed for 2 weeks after hospital discharge.

Demographics, feeding characteristics, respiratory needs, complications, discharge needs, and patient costs.

The 4932 infants admitted to the NICU with gestational ages of 32 to 34 weeks represented 24.8% of the 19,923 admissions during this time period. This cohort experienced low mortality (0.5%) and had an average length of stay (LOS) of 17.6 days. The average cost per case was $31,000, representing 21.6% of total NICU costs. Fifty-four percent of infants experienced respiratory compromise, requiring ventilation, continuous positive airway pressure, or oxygen during their hospital course. Fifty-six percent required intravenous nutrition, and 19% of these patients were discharged home with ongoing medical needs and the use of durable medical equipment.

Although morbidities with long-term consequences were rare, there is a significant burden on the infant, family, and healthcare team for patients 32 to 34 weeks' GA. It is important to understand the characteristics of this group of infants and explore ways of optimizing care to minimize this burden.