Growth disparities among NICUs: insights from the New Jersey statewide neonatal collaborative

To determine how much of the variability in growth of preterm infants is related to differences among NICUs.

The contribution of NICU of care and infant characteristics to variability in growth (weight Z-scores changes, birth to discharge) were quantified for 4459 infants (23⁰-29⁶ weeks) in the New Jersey NICU Collaborative from 2014 to 2023.

Despite increases in growth of preterm infants over years, substantial variability in growth persists. The largest contributor to this variability was the NICU of care. Adjusting for GA at birth and birth weight, race, ethnicity, and major morbidities, the effect of NICU of care remained highly significant (p < 0.001) and accounted for over 13% of the variance in growth.

There is substantial variation in growth, with NICU of care being the largest source of identified variability. Different feeding strategies and actual nutrient delivery need to be further investigated to reduce these disparities.