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Updated: Apr 17, 2026

Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
[Factors associated with prolonged hospital stay in infants]
Insights
Newborns with low birth weight, prematurity, or requiring resuscitation face longer neonatal intensive care unit (NICU) stays. Maternal factors like insufficient prenatal care and lack of health insurance also predict prolonged hospitalization, highlighting areas for improved quality indicators.
Area of Science:
- Neonatal Intensive Care
- Perinatal Epidemiology
- Healthcare Quality Assessment
Context:
- Neonatal intensive care units (NICUs) manage high-risk newborns.
- Prolonged hospital stays in NICUs are associated with increased healthcare costs and potential for hospital-acquired complications.
- Identifying predictive factors for prolonged NICU stays is crucial for resource allocation and quality improvement.
Purpose:
- To identify maternal and neonatal factors associated with prolonged hospital stays in a neonatal intensive care unit.
- To analyze the impact of pre-hospitalization maternal characteristics and neonatal admission parameters on length of stay.
Summary:
- A case-control study of 555 infants (111 prolonged stay >7 days) identified several risk factors.
- Key predictors of prolonged NICU stay included low birth weight (<2000g), prematurity (<36 weeks gestational age), need for cardiopulmonary resuscitation, and admission via emergency room or referral.
- Maternal factors such as inadequate prenatal care (<5 visits), lack of social health insurance, and high parity (≥3 pregnancies) were also significantly associated with longer hospitalizations.
Impact:
- Findings underscore the importance of social determinants of health, including health insurance and prenatal care access, in neonatal outcomes.
- Results can inform the development of targeted interventions and quality indicators for NICU care.
- Understanding these factors can aid in better predicting resource needs and improving patient management strategies within NICUs.
Objective:
To evaluate factors present on newborn admission to a neonatal intensive care and associated with a prolonged hospital stay.
Patients And Method:
Non-matched case-control study, with 555 infants, 111 with more than 7 days of hospital stay and 444 who stayed hospitalized between 1 and 7 days, between 2005 and 2010. Pre hospitalization maternal factors (age, pregnancy, health insurance, education, prenatal care, marital status, history of preeclampsia, prolonged rupture of membranes, chorioamnionitis infection) and neonatal ones (age at admission, gestational age, birth weight, gender, delivery practice, route of admission, Apgar and type of resuscitation) that were associated with prolonged hospital stay were analyzed. Analyses were conducted using STATA 11.0 and logistic regression in the multivariate analysis.
Results:
Maternal factors such as prenatal care with less than 5 doctor visits (AOR 2.7, 95% CI 1.3-5.5), lack of social health insurance (AOR 1.9, 95% CI 1.4-29), pregnant three or more times (AOR 1.7, 95% CI 1.1-2.7), neonatal birth weight under 2,000 g (AOR 4.2, 95% CI 1.9-9.5), need for cardiopulmonary resuscitation (AOR 4.2, 95% CI 2-9.1), gestational age less than 36 weeks (AOR 3.9, 95% CI 2-7.7) and admission to the neonatal unit through emergency room or referral from another hospital (AOR 2.8, 95% CI 1.7-4.6) were associated with hospital stays longer than 7 days.
Conclusions:
In-hospital complications that affect a prolonged stay at the health center were social health insurance, maternal education and prenatal care, and these should be considered in the evaluation of the hospital care quality indicators.
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