Incidence and outcome of major perinatal comorbidities of all hospitalized neonates requiring intensive and critical care: a livebirth population-based survey.

OBJECTIVES

Prevalence, outcome and causal implication of neonatal survival-associated major morbidities remain the central focus of quality improvement of maternal-fetal and neonatal medicine. We aimed to estimate baseline information of neonatal intensive and critical care by analyzing surviving data of all hospitalized neonates from livebirth population.

SUBJECTS AND

METHODS

We prospectively collected a datafile consisting of 10,840 (13.72%) cases as all hospitalized neonates from 79,012 livebirths in Handan in 2020, a sub-provincial region with 9.41 million population and intermediate-to-high level of socioeconomic development in north China. The diagnoses of diseases requiring intensive and/or critical care, and causes of deaths, were categorized, and perinatal and disease-specific risks of death were estimated by multivariable logistic regression models.

RESULTS

Livebirth-based incidence of major perinatal comorbidities were 19.7‰ for congenital pneumonia/early onset sepsis, 12.1‰ intraventricular hemorrhage, 8.7‰ birth asphyxia, 8.7‰ respiratory distress syndrome (RDS), 7.7‰ sepsis and 6.8‰ congenital anomalies (CA). Case-fatality rate (cause-specific mortality rate referring to livebirths) of major diseases were 47.1% (0.2‰) pulmonary hemorrhage, 26.9% (0.1‰) necrotizing enterocolitis, 15.6% (0.2‰) late onset sepsis, 14.1% (1.2‰) RDS, 11.3% (0.8‰) CA, and 11% (1.0‰) asphyxia. There were 242 (2.2%) died in hospital (3.1‰ of all livebirths), 52.1% being in the preterm, 49.2% in low birthweight, and <40% in those <28 weeks of gestation, or <1000 g birthweight, respectively. Death risks associated with the perinatal and neonatal morbidities were markedly declined with variable magnitudes as estimated by multivariable logistic regression models.

CONCLUSIONS

The incidence rates of major perinatal comorbidities, neonatal mortality rates, and major risks to the overall and specific outcome of all the hospitalized neonates in Handan, denote baseline characteristics and efficiency of the regional perinatal-neonatal care system.