Risk factors for length of NICU stay of newborns: A systematic review

Abstract

BackgroundThe improvement in survival of preterm infants is accompanied by an increase in neonatal intensive care unit (NICU) admissions. Prolonged length of stay in the NICU (LOS-NICU) increases the incidence of neonatal complications and even mortality and places a significant economic burden on families and strain on healthcare systems. This review aims to identify risk factors influencing LOS-NICU of newborns and to provide a basis for interventions to shorten LOS-NICU and avoid prolonged LOS-NICU.MethodsA systematic literature search was conducted in PubMed, Web of Science, Embase, and Cochrane library for studies that were published in English from January 1994 to October 2022. The PRISMA guidelines were followed in all phases of this systematic review. The Quality in Prognostic Studies (QUIPS) tool was used to assess methodological quality.ResultsTwenty-three studies were included, 5 of which were of high quality and 18 of moderate quality, with no low-quality literature. The studies reported 58 possible risk factors in six broad categories (inherent factors; antenatal treatment and maternal factors; diseases and adverse conditions of the newborn; treatment of the newborn; clinical scores and laboratory indicators; organizational factors).ConclusionsWe identified several of the most critical risk factors affecting LOS-NICU, including birth weight, gestational age, sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, and retinopathy of prematurity. As only a few high-quality studies are available at present, well-designed and more extensive prospective studies investigating the risk factors affecting LOS-NICU are still needed in the future.

Factors affecting length of stay according to bronchopulmonary dysplasia severity: a nationwide cohort study in Korea

“…The LOS of very preterm infants < 28 weeks of gestation at birth was also 1.1–1.2 times longer than that of infants ≥ 28 weeks of gestation at birth. This result conforms with a recent systematic review not limited to infants with BPD; GA and/or birth weight have also been identified as critical risk factors affecting the initial LOS [ 29 ]. The earlier the GA at birth, the more days are expected for maturation until the term-equivalent age; therefore, the LOS will become longer.…”

Colostrum immunotherapy and length of hospital stay in preterm infants: an intervention study

“…A systematic review from the year 2023 assessed 23 studies published with data from eleven countries, among these South Africa (1), Canada (1), China (4), United States of America (8), Eritrea (1), Ethiopia (1), India (2), Iran (1), Israel (1), Poland (1) and Turkey (2) and identified the gestational age, among other risk factors for higher stay of preterm newborns in NICUs, which are: birth weight, sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia and retinopathy of prematurity; and reassured the need for further studies that investigate factors that affect the duration of hospitalization of PTNBs. 26 The challenge to this risk factors may represent an improvement in the survival of preterm newborns, with impacts in the reduction of length of hospitalization, and consequently public costs with health focused on this segment of the population.…”

Efisiensi ICU Rumah Sakit Pemerintah Dengan Metode Data Envelopment Analysis (DEA)

“…Lebih tinggi dibandingkan dengan bayi yang lahir dengan usia kehamilan diatas 28 minggu, yakni mencapai 66-86 hari (Derienzo et al, 2016). Beberapa kondisi lain yang memengaruhi LOS NICU adalah perawatan antenatal ibu, kondisi ibu, penyakit dan kondisi bayi baru lahir, terapi yang diberikan, skor klinis dan hasil laboratorium (Fu et al, 2023).…”