Postpartum triage, services provided, and length of stay for infants born at 35 weeks gestation

The aim of this article is to (1) compare the care setting to which 35-week infants are initially triaged postpartum to the level of services subsequently provided; and (2) identify factors known at delivery or immediately postpartum associated with services received and length of stay during the birth hospitalization.

In this multicenter retrospective study of 35-week infants born between 2007 and 2008, service capabilities of the initial postpartum care setting were categorized as level 1 or neonatal intensive care unit (NICU) using American Academy of Pediatrics definitions. Subsequent services actually provided were categorized as routine care, level 1, or >level 1.

Over half of 431 studied infants were sent to a level 1 nursery postpartum. Of these, over 90% ultimately received routine care or level 1 services. Of 200 infants triaged to a NICU, the majority received only routine care or level 1 services. The great majority of infants requiring > level 1 services were identified promptly postpartum. Initial triage to the NICU was associated with significantly (p < 0.05) increased length of stay despite provision of similar services.

This study suggests a need for improved triage of 35-week infants and provides tools for this purpose. Validation of the models presented here is warranted.