A review of term admissions to a neonatal intensive care unit – Are some more suited for a transitional unit?

Abstract

AimThe increasing birth rate of term neonates and neonatal term admissions are placing unprecedented pressure on our neonatal resources. Transitional units may be a suitable alternative for low to moderate-risk neonates. This study reviewed admission trends of term neonates (37+0 to 41+6 weeks) admitted to the neonatal intensive care unit (NICU) at Royal Prince Alfred Hospital in Sydney, Australia. MethodsRetrospective cohort study using neonatal data from medical records. The primary outcome was to review the reasons for admission of term neonates to the NICU between 2015 and 2019. A secondary outcome was to determine term admissions suitable for a transitional unit model. Results2808 term neonates were admitted to the NICU, with respiratory distress accounting for most admissions (41%). Admissions potentially suitable for a transitional unit include hypoglycaemia, jaundice, thermoregulation and feeding issues, low birth weight and neonatal abstinence syndrome. These admissions account for over 30% of all term admissions to our NICU over the study period. ConclusionsSome low to moderate-risk term admissions may be suitable for transitional units. Implementation of transitional units may alleviate the demand on our neonatal health system and enable optimal family-centred care. Further large-scale studies of term neonates are warranted to explore the benefit of transitional care models in Australia and New Zealand.