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Published on: August 25, 2014
Digital Health as a Mechanism to Reduce Neonatal Intensive Care Unit Admissions: Retrospective Cohort Study
Alison K Brinson1,2,3, Hannah R Jahnke1, Natalie Henrich1
1Maven Clinic, New York, NY, United States.
Insights
Using a prenatal digital health platform can increase gestational age at birth and reduce the need for neonatal intensive care unit (NICU) admission. This technology supports families by providing health information and mental health resources.
Area of Science:
- Digital Health
- Maternal Health
- Neonatal Care
Background:
- Neonatal intensive care unit (NICU) admission incurs significant costs and family stress.
- Digital health interventions show potential in addressing modifiable health factors influencing NICU admissions.
Purpose of the Study:
- To examine the association between using a comprehensive prenatal digital health platform and gestational age at birth.
- To investigate how this platform use relates to mechanisms that may reduce NICU admission risk.
Main Methods:
- Analysis of data from 3326 users of a digital health platform (January 2020 - May 2022).
- Multivariable regression models assessed the link between platform use and gestational age/NICU admission risk factors.
- Analyses were stratified based on the presence of gestational conditions.
Main Results:
- Increased digital health platform use correlated positively with gestational age at birth for all users.
- Platform use was associated with increased engagement in risk-reduction mechanisms: medically accurate information, mental health management, and understanding warning signs.
- Higher gestational age at birth was linked to a decreased likelihood of NICU admission.
- Understanding warning signs via the platform reduced NICU admission odds for users with gestational conditions.
Conclusions:
- Prenatal digital health platform use is associated with improved gestational age at birth.
- Digital health tools can empower expectant parents with knowledge and resources, potentially lowering NICU admission rates.
Background:
Admission to the neonatal intensive care unit (NICU) is costly and has been associated with financial and emotional stress among families. Digital health may be well equipped to impact modifiable health factors that contribute to NICU admission rates.
Objective:
The aim of the study is to investigate how the use of a comprehensive prenatal digital health platform is associated with gestational age at birth and mechanisms to reduce the risk of admission to the NICU.
Methods:
Data were extracted from 3326 users who enrolled in a comprehensive digital health platform between January 2020 and May 2022. Multivariable linear and logistic regression models were used to estimate the associations between hours of digital health use and (1) gestational age at birth and (2) mechanisms to reduce the risk of a NICU admission. Multivariable logistic regression models estimated the associations between (1) gestational age at birth and (2) mechanisms to reduce the risk of a NICU admission and the likelihood of a NICU admission. All analyses were stratified by the presence of any gestational conditions during pregnancy.
Results:
For users both with and without gestational conditions, hours of digital health use were positively associated with gestational age at birth (in weeks; with gestational conditions: β=.01; 95% CI 0.0006-0.02; P=.04 and without gestational conditions: β=.01; 95% CI 0.0006-0.02; P=.04) and mechanisms that have the potential to reduce risk of a NICU admission, including learning medically accurate information (with gestational conditions: adjusted odds ratio [AOR] 1.05, 95% CI 1.03-1.07; P<.001 and without gestational conditions: AOR 1.04, 95% CI 1.02-1.06; P<.001), mental health management (with gestational conditions: AOR 1.06, 95% CI 1.04-1.08; P<.001 and without gestational conditions: AOR 1.03, 95% CI 1.02-1.05; P<.001), and understanding warning signs during pregnancy (with gestational conditions: AOR 1.08, 95% CI 1.06-1.11; P<.001 and without gestational conditions: AOR 1.09, 95% CI 1.07-1.11; P<.001). For users with and without gestational conditions, an increase in gestational age at birth was associated with a decreased likelihood of NICU admission (with gestational conditions: AOR 0.62, 95% CI 0.55-0.69; P<.001 and without gestational conditions: AOR 0.59, 95% CI 0.53-0.65; P<.001). Among users who developed gestational conditions, those who reported that the platform helped them understand warning signs during pregnancy had lower odds of a NICU admission (AOR 0.63, 95% CI 0.45-0.89; P=.01).
Conclusions:
Digital health use may aid in extending gestational age at birth and reduce the risk of NICU admission.
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