J Perinatol. 2025 Oct 20. doi: 10.1038/s41372-025-02449-0. Online ahead of print.
ABSTRACT
OBJECTIVE: To examine the association of admission NICU capacity strain with neonatal mortality and morbidity.
STUDY DESIGN: 2008-2021 South Carolina cohort using linked vital statistics and discharge data of 22-44 weeks GA infants, born at hospitals with ≥ level 2 unit and ≥5 births <34 weeks GA/year. The exposure was deciles of admission capacity strain, defined as the sum of infants ≤44 weeks GA with a congenital anomaly plus infants <34 weeks GA. The primary outcome was a composite of mortality and term and preterm complications. We used Poisson generalized linear mixed models to examine the association of exposure with outcome adjusting for patient and hospital characteristics.
RESULTS: We studied 64,647 infants from 30 hospitals. High capacity strain was associated with increased risk of mortality and morbidity adjusting for patient/hospital factors (for example, tenth decile aIRR 1.14, 95% CI 1.03-1.27).
CONCLUSION: Capacity strain is associated with adverse NICU outcomes.
PMID:41116036 | DOI:10.1038/s41372-025-02449-0
