Escalation of Care for Late Preterm Infants During the Birth Hospitalization
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Late preterm infants represent nearly a quarter of a million infants born in the United States annually. There is a known variation in admission location for these infants. The objective of this study was to identify the timing and reasons for transfer for late preterm infants requiring an escalation in care during the birth hospitalization. PATIENTS AND METHODS: This single-center retrospective cohort study examined the birth hospitalization for late preterm infants (34 + 0 to 36 + 6 weeks) born between 2019 and 2021, specifically focusing on infants requiring an escalation to a higher level of care. Infants with congenital anomalies expecting neonatal intensive care unit (NICU) admission were excluded. The analysis included descriptive and inferential statistics. RESULTS: Of 1022 infants, 150 symptomatic infants were admitted to the level III/IV NICU at birth. Of the remaining 872 infants, 14% (n = 124) received escalation of care (n = 77 from level I to II, 25 from level I to III/IV, 22 from level II to III/IV). The most common reasons for escalation were need for respiratory support (n = 32, 26%), cardiorespiratory monitoring (n = 31, 25%), thermoregulation (n = 29, 23%), and dextrose-containing intravenous fluids (n = 27, 22%). Infants required escalation of care at a median of 12.5 hours after birth (IQR 4-40 hours, range 0-133), with 50% (n = 62) occurring within the first 12 hours and 67% (n = 83) within 24 hours. CONCLUSIONS: Escalation of care for late preterm infants most frequently occurs in the first 24 hours after birth. The most frequent reasons for escalation were the need for respiratory support, followed by cardiorespiratory monitoring and thermoregulation.
Source: Hospital Pediatrics
Authors: Neha S. Joshi, Jochen Profit, Adam Frymoyer, Valerie J. Flaherman, Yuan Gu, Henry C. Lee
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4415945875