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Another outcome of neonatal intensive care: first year mortality and hospital morbidity
1Department of Paediatrics, National Women's Hospital, University of Auckland, New Zealand.
Objective:
To determine first year mortality and hospital morbidity after neonatal intensive care.
Methodology:
Cohort study of 6077 surviving infants inborn in one regional hospital in 1988. Nine hundred and eighty-eight received neonatal intensive care and 103 were very low birthweight (VLBW).
Results:
For infants who required care in the neonatal intensive care unit (NICU), the relative risk of dying before their first birthday was 3.6 (95% confidence intervals [CI] 1.5-8.8). This increased risk was associated with low birthweight (LBW) rather than requirement for NICU care. Of all inborn survivors, 10.4% were readmitted to hospital in the first year and 2.4% more than once. The readmission rate was 20% for NICU survivors and 30% for VLBW infants. The risk of hospitalization was independently associated both with NICU admission (odds ratio 2.3, CI 1.9-2.9) and with VLBW (OR 1.8, CI 1.1-3.0). The NICU survivors also had multiple admissions and prolonged hospital stays.
Conclusions:
Both low birthweight and neonatal illness requiring intensive care are important indicators of continuing medical vulnerability over the first year of life.