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Neonatal intensive care admissions: changing profile in Georgia, 1974 to 1982
R L Floyd1, C C Murphy, J Dillon
1Department of Pediatrics, Emory University School of Medicine, Atlanta, Ga.
Southern Medical Journal
|July 1, 1989
Summary
Neonatal intensive care unit admissions increased for low birthweight infants, while decreasing for higher birthweight infants. Improved survival rates were observed for infants under 1,500 gm, despite some centers showing increased mortality in heavier infants.
Area of Science:
- Perinatal Medicine
- Neonatal Care
- Public Health
Background:
- Regionalization of perinatal care aimed to centralize resources for high-risk infants.
- Trends in neonatal intensive care unit (NICU) admissions and outcomes by birthweight were not fully characterized during the early implementation of regional systems.
Purpose of the Study:
- To analyze birthweight-specific admission and mortality trends in Georgia's regional perinatal centers from 1974 to 1982.
- To assess the impact of regionalization on NICU utilization and infant survival across different birthweight strata.
Main Methods:
- Retrospective review of birthweight-specific admission and mortality data from 1974 to 1982.
- Analysis of NICU admissions as a proportion of total live births and total NICU admissions.
- Examination of mortality data including neonatal, postneonatal, and infant mortality.
Main Results:
- An increasing trend in NICU admissions was observed for infants weighing 1,000-1,499 gm, and a decreasing trend for infants weighing 2,000 gm or more, relative to total live births.
- Significant increases in NICU admissions were noted for all birthweight groups under 2,000 gm, with decreases for those over 2,000 gm, relative to total NICU admissions.
- Improved survival rates were found for infants weighing less than 1,500 gm, but some centers reported increased mortality for infants weighing 2,500 gm or more.
Conclusions:
- Low birthweight infants constituted an increasing proportion of NICU admissions during the study period.
- The observed trends in NICU utilization and outcomes are linked to the gradual implementation of regional perinatal care and associated cost factors.
- Regionalization influenced NICU admission patterns, shifting focus towards lower birthweight infants and necessitating ongoing evaluation of cost-effectiveness and outcomes across all weight groups.