Changes in Hospital Care of Newborn Infants with Trisomy 13.

OBJECTIVE

To examine the changes over recent years in neonatal survival to discharge, prevalence of adverse events, surgical procedures, tracheostomy and/or gastrostomy tube (G-tube) placement, and length of stay (LOS) in infants with Trisomy 13.

METHODS

We identified newborn infants with Trisomy 13 in the National Inpatient Sample in the years 2003-2018. We calculated prevalence of associated conditions. We examined procedures done, and common adverse events associated with each condition, survival rates, and LOS. We also calculated changes in trends over the years.

RESULTS

The study identified 5792 newborn infants with Trisomy 13. Mortality during neonatal period was 58%. There was no significant change in mortality trends over the years, (p < 0.001). Average LOS was 10 (+ 34) days which had significantly increased over recent years (p < 0.001) and it was highest in conditions of NEC followed by gastrointestinal anomalies and sepsis. Among survivors, 2% were discharged with tracheostomy and 9% with G-tubes. LOS was significantly increased in association with these procedures.

CONCLUSION

There was a slight decrease in infants admitted to neonatal intensive care units with Trisomy 13 over recent years. In-hospital neonatal mortality was unchanged. However, there was a significant increase in LOS, which was increased with procedures such as tracheostomy and G-tube placement, which may reflect a trend toward increasing interventions without a corresponding improvement in mortality.