Carbon footprint associated with neonatal intensive care unit admission of very preterm infants: A retrospective pilot study applying life cycle assessment.

UNLABELLED: Health care contributes an estimated 4.4-5% of global greenhouse gas emissions, yet life cycle assessment (LCA) data specific to neonatal intensive care remain scarce. This pilot study aimed to estimate the carbon footprint associated with the neonatal intensive care unit (NICU) admission of very preterm infants (28-32 weeks' gestation) and to identify the main emission "hotspots". Observational, retrospective, single-center study applying LCA methodology to a cohort of very preterm infants consecutively admitted to a level IIIA NICU. Emissions from energy consumption, medication, disposable supplies, feeding, and diagnostic tests were estimated in kilograms of carbon dioxide equivalent (kg CO₂e) per admission, using emission factors from previously published literature and, when unavailable, an input-output analysis relating product price to the most specific published emission factor. Twenty-two newborns were analyzed. The median total carbon footprint was 1220.15 kg CO₂e per admission (interquartile range [IQR] 1034.44-1497.94), equivalent to 34.07 kg CO₂e per patient per day. Disposable supplies were the largest contributor (72.1% of the total), driven mainly by daily hygiene products-particularly the pulse oximetry sensor cable and nitrile gloves-followed by electrical equipment (15.5%), dominated by incubator use.

CONCLUSION: This pilot study provides one of the first LCA-based estimates of the environmental footprint of NICU care for very preterm infants, identifying disposable supplies and incubator energy use as priority targets for mitigation. Larger, multicenter studies are needed to confirm these findings and to guide sustainable neonatal care practices.

WHAT IS KNOWN: • Health care is a major contributor to global emissions; critical care generates 88-178 kg CO₂e/day, but neonatal-specific LCA data are lacking.

WHAT IS NEW: • First LCA estimate for very preterm NICU care (1,220 kg CO₂e/admission); disposable hygiene supplies, not equipment, are the leading hotspot.